PMID- 24439324 OWN - NLM STAT- MEDLINE DCOM- 20140428 LR - 20220419 IS - 1097-6809 (Electronic) IS - 0741-5214 (Linking) VI - 59 IP - 3 DP - 2014 Mar TI - A systematic review and meta-analysis of abdominal compartment syndrome after endovascular repair of ruptured abdominal aortic aneurysms. PG - 829-42 LID - S0741-5214(13)02212-X [pii] LID - 10.1016/j.jvs.2013.11.085 [doi] AB - OBJECTIVE: Limited data exist regarding the development of abdominal compartment syndrome (ACS) after endovascular repair of ruptured abdominal aortic aneurysms (RAAAs). We aimed to record the incidence, management, and outcome of this complication. METHODS: A systematic review and meta-analysis of the English language literature was undertaken through June 2012. Articles reporting data on outcome after endovascular repair of RAAAs were identified, and information regarding ACS was sought. RESULTS: Included were 39 eligible studies reporting 1134 patients. The pooled perioperative mortality was 21% (95% confidence interval [CI], 18%-24%). A total of 109 cases of ACS were recorded. There was significant within-study heterogeneity (Cochran Q = 94.1; P < .0001), and the pooled ACS rate was 8% (95% CI, 5.6%-10.8%). Only six studies accurately defined ACS, and four focused specifically on ACS. When the meta-analysis was repeated after including only studies with a definition and those focusing on ACS, the pooled rate increased to 17% (95% CI, 10%-26%) and 21% (95% CI, 13%-30%), respectively. A random-effects meta-regression analysis investigating the effect of ACS and other risk factors on mortality revealed a significant linear correlation between hemodynamic instability and death (r = 0.303) and a nonlinear (second degree polynomial) association between bifurcated endograft approach and death (R(2) = 0.348; P = .0027). However, no statistically significant association could be found between ACS and death. A further meta-regression analysis failed to identify any statistically significant predictors of ACS. Treatment included open decompression in 86 patients, percutaneous drainage in 18 (catheter only in five, combined with tissue plasminogen activator infusion in 13), and conservative measures in five. Data on outcome of ACS were only available for 76 patients; 35 of these died, for a mortality rate of 47%. CONCLUSIONS: The pooled ACS rate was calculated at 8%, but this figure may be >20% with improved awareness and vigilant monitoring. Although no statistically significant association could be found between ACS and death, almost half the patients who developed ACS after endovascular repair of RAAAs were likely to die. CI - Copyright (c) 2014 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved. FAU - Karkos, Christos D AU - Karkos CD AD - Fifth Department of Surgery, Medical School, Aristotle University of Thessaloniki, Hippocrateio Hospital, Thessaloniki, Greece. Electronic address: ckarkos@hotmail.com. FAU - Menexes, Georgios C AU - Menexes GC AD - School of Agriculture; Aristotle University of Thessaloniki, Thessaloniki, Greece. FAU - Patelis, Nikolaos AU - Patelis N AD - First Department of Surgery, National Kapodistrian University of Athens, Laiko Hospital, Athens, Greece. FAU - Kalogirou, Thomas E AU - Kalogirou TE AD - Fifth Department of Surgery, Medical School, Aristotle University of Thessaloniki, Hippocrateio Hospital, Thessaloniki, Greece. FAU - Giagtzidis, Ioakeim T AU - Giagtzidis IT AD - Fifth Department of Surgery, Medical School, Aristotle University of Thessaloniki, Hippocrateio Hospital, Thessaloniki, Greece. FAU - Harkin, Denis W AU - Harkin DW AD - Regional Vascular Surgery Unit, Royal Victoria Hospital, Belfast, Northern Ireland, United Kingdom. LA - eng PT - Journal Article PT - Meta-Analysis PT - Review PT - Systematic Review DEP - 20140116 PL - United States TA - J Vasc Surg JT - Journal of vascular surgery JID - 8407742 SB - IM MH - Aortic Aneurysm, Abdominal/mortality/physiopathology/*surgery MH - Aortic Rupture/mortality/physiopathology/*surgery MH - Blood Vessel Prosthesis Implantation/*adverse effects/mortality MH - Decompression, Surgical MH - Drainage MH - Endovascular Procedures/*adverse effects/mortality MH - Hemodynamics MH - Humans MH - Incidence MH - Intra-Abdominal Hypertension/diagnosis/*etiology/mortality/physiopathology/therapy MH - Nonlinear Dynamics MH - Reoperation MH - Risk Factors MH - Treatment Outcome EDAT- 2014/01/21 06:00 MHDA- 2014/04/29 06:00 CRDT- 2014/01/21 06:00 PHST- 2013/01/08 00:00 [received] PHST- 2013/10/19 00:00 [revised] PHST- 2013/11/23 00:00 [accepted] PHST- 2014/01/21 06:00 [entrez] PHST- 2014/01/21 06:00 [pubmed] PHST- 2014/04/29 06:00 [medline] AID - S0741-5214(13)02212-X [pii] AID - 10.1016/j.jvs.2013.11.085 [doi] PST - ppublish SO - J Vasc Surg. 2014 Mar;59(3):829-42. doi: 10.1016/j.jvs.2013.11.085. Epub 2014 Jan 16.