Abstract:
BACKGROUND:We aimed to investigate whether the transfusion of 2 units of fresh frozen plasma (FFP) immediately post aneurysm exclusion has any effect on the perioperative fibrinogen levels and the outcome of patients undergoing elective endovascular repair (EVAR) of abdominal aortic aneurysm (AAA). METHODS:Consecutive infrarenal AAA patients undergoing elective EVAR with the bifurcated Endurant-II stent-graft (Medtronic) were recruited from 2 vascular units. The first unit has a routine policy of administering 2 units of FFP immediately upon aneurysm exclusion (FFP group), whereas the second unit has no such policy (control group). Serum fibrinogen levels were measured on admission and 24 hr post-EVAR and the perioperative change in fibrinogen (Δfib) was calculated (24-hr postoperative minus preoperative fibrinogen). The 2 groups were compared with regards to the perioperative fibrinogen levels (preoperative, 24-hr postoperative, and Δfib) and the outcome (endoleaks, reinterventions, major adverse cardiovascular events, death) during follow up. RESULTS:A total of 70 patients (41 in the FFP group, 29 controls) were examined. There were 68 men, the mean age was 70 ± 7 years and the maximum AAA diameter was 63.3 ± 13.8 mm. During the follow up (34 ± 19 months), a total of 6 endoleaks were recorded (2 type Ia, 2 type Ib and 1 type II). Mean preoperative fibrinogen, 24-hr postoperative fibrinogen and Δfib was 391.1 ± 92.8 mg/dL, 367.7 ± 97.8 mg/dL and -23.5 ± 51.02 mg/dL, respectively. There was a trend for the fibrinogen to fall 24 hr postprocedure, but this was not statistically significant (P = 0.07). There was a weak negative association between Δfib and endoleaks (P = 0.007, r = -0.29). Compared to controls, the FFP group had a higher 24-hr postoperative fibrinogen (401.8 ± 112.9 mg/dL vs. 319.3 ± 34.9 mg/dL, P < 0.0001) and a lower Δfib (-3.00 ± 56.01 mg/dL vs. -52.48 ± 21.15 mg/dL, P < 0.0001). No significant difference was observed between the 2 groups with regards to endoleaks, reinterventions, major adverse cardiovascular events, or deaths. CONCLUSIONS:Transfusion of 2 units of FFP postaneurysm exclusion prevents a significant drop in plasma fibrinogen 24 hr post-EVAR, but the impact on clinical outcome has yet to be defined.
journal_name
Ann Vasc Surgjournal_title
Annals of vascular surgeryauthors
Kapetanios D,Petropoulou M,Chatzelas D,Pitoulias G,Kalogirou TE,Mitka AM,Giagtzidis IT,Papazoglou KO,Karkos CDdoi
10.1016/j.avsg.2020.09.003subject
Has Abstractpub_date
2020-09-16 00:00:00eissn
0890-5096issn
1615-5947pii
S0890-5096(20)30837-2pub_type
杂志文章abstract::We describe a case of gluteal compartment syndrome (GCS) after a 4-vessel fenestrated endovascular abdominal aortic aneurysm repair. The case highlights the need for a high index of suspicion for GCS as a differential diagnosis for spinal cord ischemia in patients developing perioperative lower limb neurologic deficit...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.07.029
更新日期:2016-01-01 00:00:00
abstract::From 1990 to 1992 there was a 43% increase in the number of carotid endarterectomies (CEAs) performed at our institution. Not coincidentally the North American Symptomatic Carotid Endarterectomy Trial study was published in August 1991. To determine whether CEAs could be performed safely at community medical centers, ...
journal_title:Annals of vascular surgery
pub_type: 临床试验,杂志文章
doi:10.1007/BF02133062
更新日期:1994-09-01 00:00:00
abstract:BACKGROUND:The etiology of postoperative delirium (POD) following vascular surgery is generally unknown. The incidence, however, can be as high as 35%. A possible neuroinflammatory basis for delirium is likely and C-reactive protein (CRP) as a marker for inflammation can possibly play a predictive role. METHODS:Betwee...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2014.07.004
更新日期:2014-11-01 00:00:00
abstract::This article describes a great saphenous vein spiral graft technique for reconstruction of iliac vessels after en bloc resection during pelvic exenteration. Use of different size syringes as a scaffold allows the surgeon to construct autologous vascular interposition conduits of variable diameter to match the luminal ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.01.028
更新日期:2015-08-01 00:00:00
abstract::Primary subclavian vein stents are not recommended for venous thoracic outlet syndrome before surgical decompression by first rib resection due to a high risk of fracture because they are compressed between the clavicle and first rib. After rib removal, however, stent insertion has been advocated for venous restenosis...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.04.064
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Studies suggest 25% of patients with symptomatic peripheral arterial disease develop symptom progression over time, yet there is minimal data related to actual atherosclerotic progression. METHODS:Patients who underwent consecutive duplex imaging of the lower limb arteries, at least 6 months apart with no i...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2017.04.033
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:Endovascular management of complex aortoiliac occlusive disease (AIOD) has been described as a viable alternative to open surgical reconstruction. To date, few studies have directly compared the 2 techniques. We therefore, evaluated short and mid- term outcomes of open and endovascular therapy in TASC II D A...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.06.005
更新日期:2019-11-01 00:00:00
abstract::The need for enhanced surgical exposure for the high extracranial (Zone III) internal carotid artery is not uncommon. In certain circumstances, the posterior border and angle of the mandible may interfere with access to the distal internal carotid artery (ICA). The use of modified mandibular osteotomies has provided v...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02007006
更新日期:1992-09-01 00:00:00
abstract::Although transperitoneal surgical repair has been the gold standard for patients with a suspected ruptured abdominal aortic aneurysm (rAAA), the retroperitoneal approach and endovascular aortic repair (EVAR) are increasingly being recommended as preferred approaches due to lower morbidity and mortality. To highlight t...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2006.10.019
更新日期:2007-03-01 00:00:00
abstract:BACKGROUND:Despite an aggressive climate of limb salvage and revascularization, 7% of patients with peripheral artery disease undergo major lower extremity amputation (LEA). The purpose of this study was to describe the current demographics and early outcomes of patients undergoing major LEA in the Vascular Quality Ini...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2017.07.034
更新日期:2018-01-01 00:00:00
abstract::We report a reoperation case of a ruptured infectious aortic arch pseudoaneurysm, which was stabilized with thoracic endovascular aortic repair and snorkel bypass of the innominate artery (IA) and the left common carotid artery (LCCA). A 57-year-old Chinese woman with multiple comorbidities and previous open repair fo...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.09.035
更新日期:2017-05-01 00:00:00
abstract::Routine intraoperative imaging of the carotid artery following carotid endarterectomy can detect defects at the site of endarterectomy that may lead to neurologic morbidity. A number of methods have been used to evaluate the completed endarterectomy. In this prospective study we compared subjective methods of assessme...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02135281
更新日期:1995-05-01 00:00:00
abstract::Endoleaks remain a significant challenge after endovascular abdominal aortic aneurysm repair (EVAR). Translumbar thrombin injection of the aneurysm sac has been used to treat endoleaks, with low reported morbidity. We present an unusual case of ischemic colitis following translumbar thrombin injection of an endoleak. ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-003-0102-2
更新日期:2004-01-01 00:00:00
abstract::This case report describes a pediatric patient with mycotic aneurysms of both posterior tibial arteries and the right peroneal artery associated with an episode of endocarditis. To our knowledge, this case represents the first reported occurrence of multiple mycotic aneurysms of the tibioperoneal arteries. It is also ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169900240
更新日期:1999-03-01 00:00:00
abstract:BACKGROUND:Hyperbaric oxygen (HBO) is used as an adjunctive therapy for a variety of indications. However, there is a lack of high-quality research evaluating HBO treatment outcomes for different indications available in the current literature. METHODS:We retrospectively reviewed all patients who underwent HBO therapy...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2014.07.034
更新日期:2015-02-01 00:00:00
abstract::Beginning in April 1989, we have performed eight upper thoracic chemical sympathectomies by transthoracic endoscopy. The indications were occlusive arterial disease in four patients and Raynaud's syndrome and palmar hyperhidrosis in two patients each. Transthoracic endoscopy was performed under general anesthesia, thr...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02008799
更新日期:1992-07-01 00:00:00
abstract:BACKGROUND:In abdominal aortic aneurysm (AAA), pathophysiology deterioration of the medial aortic layer plays a critical role. Key players in vessel wall degeneration are reactive oxygen species (ROS), smooth muscle cell apoptosis, and extracellular matrix degeneration by matrix metalloproteinase-9 (MMP-9). Lipocalin-2...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2018.11.006
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Venous resection during pancreaticoduodenectomy for the excision of pancreatic cancer allows for a more complete resection with negative margins, which increases survival. When the resected vein is greater than 3 cm, reconstruction with an interposition graft is recommended. However, consensus regarding the ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.11.008
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:Medical care in the United States has evolved into a more cost-conscious value-based health care system that necessitates a comparison of costs when there are alternative interventions considered to be acceptable in the treatment of a disease. This study compares the cost differences between regional anesthe...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.05.124
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:Ehlers-Danlos syndrome (EDS) is a hereditary connective tissue disorder caused by mutations in genes involved with collagen matrix formation that results in weakened blood vessels. Endovascular therapy on patients with EDS is fraught with concerns of vessel dissection and access site complications. We descri...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2011.05.028
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Delirium in patients with critical limb ischemia (CLI) is associated with increased mortality. The main goal of this study was to investigate the association between delirium and mortality in patients undergoing major lower limb amputation for CLI. In addition, other risk factors associated with mortality we...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.02.014
更新日期:2019-10-01 00:00:00
abstract::A 21-year-old man was referred to our department for treatment of multiple aneurysms, including bilateral renal artery aneurysms. He was clinically diagnosed with Loeys-Dietz syndrome. So, we developed a 2-stage surgical strategy. The first surgery involved reconstructing the right renal artery and replacing part of t...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2018.10.032
更新日期:2019-05-01 00:00:00
abstract::Performance of carotid endarterectomy for asymptomatic carotid stenosis has been restricted during recent years because of concern of reported complications in as high as 10-15% of patients, as well as limited long-term data on stroke protection. During the last 10 years, we have studied immediate and long-term result...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02016741
更新日期:1991-03-01 00:00:00
abstract::Longitudinal elasticities of whole human blood clot, whole canine blood clot, Factor XIII cross-linked fibrin, glutaraldehyde-fixed human albumin, and formaldehyde-fixed collagen, gelatin and collagen/gelatin were determined and normalized to human whole blood clot. Matrices of a knitted Dacron graft were then impregn...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02042732
更新日期:1992-03-01 00:00:00
abstract::Bacillus Calmette-Guérin (BCG) therapy is often associated with side effects. The most feared is disseminated sepsis that may occur rarely with the development of mycotic aortic aneurysms. Twenty cases of patients treated with intravesical BCG complicated by mycotic abdominal aortic aneurysm have been reported in the ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.01.036
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:Basilic vein transposition via single long incision is a renowned technique despite its known wound-related complications. Contrary to that, multiple skip incisions technique is thought to have relatively lower wound-related complications. But to the best of our knowledge, these 2 techniques have never been ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2018.01.083
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:There is increasing recognition that decreased reserve in multiple organ systems, known as accumulated deficits (AD), may better stratify perioperative risk than traditional risk indices. We hypothesized that an AD model would predict both perioperative adverse events and long-term survival after carotid end...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2017.06.150
更新日期:2018-01-01 00:00:00
abstract::Emergency aortic arch surgery still remains a challenge, especially in elderly patients. We report a case about the open surgical management by graft-to-endograft anastomosis of a complicated aortic arch aneurysm because of a type I endoleak after thoracic endovascular aortic repair of a chronic type B aortic dissecti...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2010.11.015
更新日期:2011-05-01 00:00:00
abstract::Spontaneous venous aneurysms of the upper extremities and neck are rare and typically asymptomatic. We present the first reported case of a symptomatic, primary upper extremity venous aneurysm in a patient who initially presented with pulmonary emboli. A 22-year-old patient was admitted with chest pain, dyspnea, and a...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2012.05.019
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:Many individuals who are candidates for thoracic endovascular aortic repair (TEVAR) are found to have iliac artery anatomy and/or disease that preclude transfemoral endovascular access and require retroperitoneal surgical approach through more proximal arteries. This relatively more invasive technique could ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2010.09.015
更新日期:2011-04-01 00:00:00