Abstract:
:Ruptured abdominal aortic aneurysm (AAA) remains a common and highly lethal problem. This study evaluates the morbidity and mortality rates and aims to identify which clinical variables could predict the outcome. We reviewed the records of 112 patients (97 men and 15 women) operated on for ruptured infrarenal AAA within the past 12 years (April 1, 1980, to March 31, 1992). Forty-seven clinical variables were collected and correlated with outcome by univariate and multivariate analysis. Mean age was 72.4 years (range 51 to 89 years). Only 12.5% were known to have an AAA before rupture. Preoperative systolic pressure < 90 mm Hg was present in 84 patients (75%) and 11 patients (9.8%) experienced cardiac arrest before surgery. The in-hospital mortality rate was 49.1% (55/112). Two preoperative variables were associated with increased mortality: systolic pressure < 90 mm Hg and cardiac arrest (p = 0.04 and p = 0.009, respectively). Preoperative comorbidity had no impact on outcome. Massive blood loss (> or = 5000 ml) was an intraoperative factor predictive of increased mortality (p = 0.0007). After multivariate analysis, only the following five postoperative variables were associated with increased mortality: cardiac event, renal failure requiring dialysis, coagulopathy, bleeding, and multisystem organ failure (all p < 0.05). We did not identify a preoperative factor that predicts certain death and allows us to deny a patient a chance at survival. The occurrence of multisystem organ failure is associated with no survivors and raises the ethical issue of withholding treatment for these patients in the postoperative course. We favor selective screening and aggressive elective repair to improve survival by operating before rupture occurs.
journal_name
Ann Vasc Surgjournal_title
Annals of vascular surgeryauthors
Panneton JM,Lassonde J,Laurendeau Fdoi
10.1007/BF02018826subject
Has Abstractpub_date
1995-11-01 00:00:00pages
535-41issue
6eissn
0890-5096issn
1615-5947pii
S0890-5096(06)60411-1journal_volume
9pub_type
杂志文章abstract::Our patient is a 44-year-old woman who underwent exploratory laparotomy with total abdominal hysterectomy and bilateral salpingo-oophorectomy by gynecologic oncology for a suspected malignancy. The diagnosis of intravenous leiomyomatosis (IVL) was made instead. She was followed by her gynecologist and remained asympto...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2018.05.061
更新日期:2018-11-01 00:00:00
abstract:BACKGROUND:Endovenous ablation of great (GSV) and short saphenous vein (SSV) reflux has become the initial procedure for most patients with symptomatic venous insufficiency, and perforator ablation is increasingly used to assist in healing venous ulceration. Many patients have comorbid conditions, which require long-te...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2011.10.019
更新日期:2012-07-01 00:00:00
abstract:BACKGROUND:Redo area region operation is associated with a significant morbidity such as neurovascular injury, infection, and lymphorrhea. The traditional management of occluded femoropopliteal grafts often includes redissection of a scarred groin to obtain adequate inflow via the common femoral artery. These procedure...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2018.04.013
更新日期:2018-10-01 00:00:00
abstract::Prolonged use of fibrinolytic agents post thrombectomy is limited by present techniques that require arterial puncture and indwelling arterial catheters. This limitation can be avoided by attaching a short segment of saphenous vein to the arteriotomy used for the thrombectomy and bringing this out to the skin as a "ve...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169900089
更新日期:1997-09-01 00:00:00
abstract::The need to treat an abdominal aortic aneurysm (AAA) in kidney transplanted patient is a rare event. To date, no method to protect the kidney during the aneurysm treatment has been identified as undeniably relevant. On the other hand, the advantage of endovascular treatment of the aneurysm (EVAR) is to avoid transplan...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.04.058
更新日期:2015-08-01 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::A patient presenting with urinary retention was found to have progressive spinal cord ischemia subsequent to an end-to-side aortobifemoral bypass for atherosclerotic disease. This serves as a vivid reminder of the possibility of this complication even in ischemic disease and that urinary retention may be the initial s...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1007/BF02000153
更新日期:1993-11-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to characterize utilization and outcomes of thoracic endovascular aortic aneurysm repair (TEVAR) in New York State during the first decade of commercial availability, with respect to evolving indications, results, and costs. Of specific interest was evaluation of the volume-outc...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2018.03.029
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Inferior vena cava filters (IVCFs) are indicated for therapeutic and prophylactic treatment of venous thromboembolism in patients when anticoagulation has failed or is contraindicated. Retrievable IVCFs are not always retrieved despite clinical recommendations. The purpose of this review is to compare result...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2018.02.010
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:Postoperative ischemic colitis (POIC) remains a frequent and extremely severe complication of infrarenal abdominal aorta surgery. However, its diagnosis and treatment are not always consensual because the incidence is very small. The aim of this retrospective study was to evaluate the prognostic factors of s...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2010.02.054
更新日期:2011-07-01 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::A 55-year-old woman with a history of hypertension, bilateral renal artery disease with a left renal artery stent, and a chronically occluded right renal bypass graft presented with anuria and acute renal failure. Diagnostic studies showed high-grade renal artery in-stent stenosis with thrombotic occlusion of the main...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2010.03.013
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:Angiography remains the gold standard imaging modality before infrainguinal bypass. Computed tomography angiography (CTA) and magnetic resonance angiography (MRA) have emerged as noninvasive alternatives for preoperative imaging. We sought to examine contemporary trends in the utilization of CTA and MRA as i...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.avsg.2015.03.039
更新日期:2015-08-01 00:00:00
abstract:OBJECTIVE:The safety and efficacy of right axillary cannulation during complex aortic aneurysm repair for the deployment of chimney grafts is controversial, however there are few studies that compare right and left upper extremity access . We favor the right axillary approach because of the relative ease of access to t...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2020.10.028
更新日期:2020-11-26 00:00:00
abstract:BACKGROUND:Length of stay (LOS) is a commonly used metric to optimize value in medical care. Although pathways have been developed for some procedures in vascular surgery to reduce LOS, they do not yet exist for thoracic endovascular aortic repair (TEVAR). The purpose of this study is to identify and define the risk fa...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2018.06.027
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:We investigated the outcome of vein stenting placement for chronic proximal venous outflow obstruction (PVOO) in a predominantly Asian-American cohort to improve patient selection, enhance technical approach, and better define quality measurements of this emerging vascular intervention. METHODS:A total of 4...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2020.01.018
更新日期:2020-07-01 00:00:00
abstract::The authors report a case of leiomyosarcoma of the inferior vena cava, responsible for an acute Budd-Chiari syndrome. The diagnosis, suggested by lower limb edema, ascites, and renal failure, was confirmed by sonography, CT scan, and pathological examination. A mesoatrial shunt and right atrial thrombectomy were perfo...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/S0890-5096(07)60039-9
更新日期:1989-07-01 00:00:00
abstract:BACKGROUND:Abdominal aortic aneurysm (AAA) is a common and lethal disease. AAAs are associated with atherosclerosis, chronic inflammation, and extracellular matrix degradation. The aim of this study was to determine whether treatment with simvastatin can influence the development of experimental aortic aneurysms in a r...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2011.09.003
更新日期:2012-02-01 00:00:00
abstract::Iliac artery aneurysms are rare in the absence of concomitant abdominal aortic aneurysm (AAA), and isolated internal iliac (hypogastric) aneurysms in particular are extremely rare. From 1986 to 1997 we repaired 572 aortic and/or iliac artery aneurysms in 440 patients. Among these there were only seven hypogastric aneu...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1007/s100169900296
更新日期:1999-09-01 00:00:00
abstract:BACKGROUND:Endovenous thermal ablation has become the procedure of choice in the treatment of superficial venous reflux disease. The current armamentarium of devices and techniques aimed at the elimination of saphenous reflux offers surgeons and interventionalists a variety of treatment options; however, there is a lac...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.05.059
更新日期:2020-01-01 00:00:00
abstract::Historically, immune-mediated degradation and subsequent aneurysm formation have limited the usefulness of cryopreserved arterial allografts. This study tested the hypothesis that modern cryopreserved arterial allografts are protected from immune-mediated dilation. Abdominal aortas were harvested from anesthetized rat...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-001-0072-1
更新日期:2002-11-01 00:00:00
abstract::Fibro-adipose vascular anomaly (FAVA) is a painful complex vascular malformation, characterized by muscle fibrofatty infiltration, usually in lower limb, associated with contracture of the ipsilateral extremity. This article describes the first case of FAVA reported in Portugal successfully treated with surgery. A 9-y...
journal_title:Annals of vascular surgery
pub_type:
doi:10.1016/j.avsg.2020.01.089
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:Renal vein aneurysms (RVAs) are uncommon entities, which are usually incidental findings or may cause mild nonspecific symptoms. Modern radiological imaging, mainly multislice computed tomography (CT), has substantially contributed to a prompt and accurate diagnosis. Treatment may range from watchful waiting...
journal_title:Annals of vascular surgery
pub_type:
doi:10.1016/j.avsg.2019.08.075
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND:Current blunt thoracic aortic injury (BTAI) guidelines recommend early repair of traumatic pseudoaneurysms (PSAs) due to risk for subsequent aortic rupture. Recent analyses indicate that early repair is required only in the setting of high-risk features, while delayed repair is safe and associated with lower...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2016.02.021
更新日期:2016-08-01 00:00:00
abstract::Between 1984 and 1991 a total of 200 patients underwent heart transplantation in our unit. The records of 121 patients who were followed up for more than 1 year were reviewed for peripheral vascular abnormalities, which were found in 12 (9.9%). Most of these patients underwent transplantation for ischemic heart diseas...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02018174
更新日期:1994-05-01 00:00:00
abstract:BACKGROUND:The possibility of predicting severe compartment syndrome using simple biochemical parameters was evaluated in a single-center study of 55 patients who presented with acute femoral embolism and who were treated with open surgical embolectomy. METHODS:Parameters related to tissue damage and oxidative metabol...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2012.12.006
更新日期:2014-01-01 00:00:00
abstract::Resistance to activated protein C (RAPC) is a newly recognized hypercoagulable state that was first described in 1993. It has become apparent that RAPC is even more common than deficiencies in protein C, protein S, or antithrombin III (AT-III) and affects an estimated 5% of the general population. The majority of pati...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02000762
更新日期:1996-03-01 00:00:00
abstract:BACKGROUND:Aortic thrombus in the absence of atherosclerotic plaque or aneurysm is rare, and its optimal management remains unclear. Although atypical aortic thrombus (AAT) has been historically managed operatively, successful nonoperative strategies have been recently reported. Here, we report our experience in treati...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2014.03.028
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:Embolic stroke is a formidable complication of transcatheter aortic valve implantation (TAVI) and thoracic endovascular aortic repair (TEVAR). Mechanical strategies to reduce the risk of ischemic embolic lesions include embolic protection devices (EPDs) and carbon dioxide flushing (CDF). This study aims to a...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2018.06.035
更新日期:2019-02-01 00:00:00
abstract::The great saphenous vein (GSV) is unusable in 20% of cases. The best alternative in these cases is the GSV of the contralateral lower limb (CLL). However, many surgeons are reluctant to harvest the contralateral GSV for fear that it might be needed for future treatment of critical ischemia in the CLL. The purpose of t...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-006-9089-9
更新日期:2006-11-01 00:00:00