National outcomes after open repair of abdominal aortic aneurysms with visceral or renal bypass

Annals of Vascular Surgery
Michelle C MartinMarc L Schermerhorn

Abstract

We evaluated national outcomes after open repair of abdominal aortic aneurysms (AAAs) with visceral or renal bypass (VRB). Using the National Inpatient Sample database from 1993 through 2006, AAA repairs were identified by ICD9 codes for diagnosis of intact AAA combined with a procedure of open AAA repair. VRB patients also had an aortorenal and/or mesenteric bypass or mesenteric endarterectomy. Dissections as well as thoracic and thoracoabdominal aneurysms were excluded. Demographics and comorbidities were noted. Mortality and complications were compared to infrarenal AAA (IRA) repairs without VRB. Predictors of perioperative mortality were analyzed by multivariate logistic regression. A total of 41,166 VRB and 362,808 IRA repairs were identified. VRB repair volume decreased by 58% and IRA volume decreased by 59% from 1993 to 2006. VRB patients had higher mortality (5.8% vs. 4.4%, p < 0.001) and more complications including acute renal failure (9.5% vs. 6.0%, p < 0.001), acute mesenteric ischemia (2.0% vs. 1.2%), and bowel resection (1.1% vs. 0.8%, p < 0.01). Patients requiring a bowel resection or with acute renal failure were 10 times more likely to die within the hospital stay regardless of repair type. Independent preopera...Continue Reading

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Citations

Feb 19, 2016·The Korean Journal of Thoracic and Cardiovascular Surgery·Yun-Ho Jeon, Chi-Hoon Bae
Mar 13, 2014·Journal of the Formosan Medical Association = Taiwan Yi Zhi·Jian-Cheng ZhuHui Xu
Dec 20, 2011·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·S W GrantC N McCollum
Feb 7, 2012·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·R SpearS Haulon
Jul 5, 2011·Journal of Vascular Surgery·Virendra I PatelRichard P Cambria
Nov 23, 2011·Journal of Vascular Surgery·Nanette R ReedPeter Gloviczki
Nov 30, 2014·Annals of Vascular Surgery·J P HunterM L Nicholson
May 2, 2012·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Renato MertensJeanette Vergara

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