PMID- 29034016
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201001
IS  - 1881-641X (Print)
IS  - 1881-6428 (Electronic)
IS  - 1881-641X (Linking)
VI  - 10
IP  - 1
DP  - 2017 Mar 24
TI  - Improved Outcomes for Ruptured Abdominal Aortic Aneurysms Using Integrated 
      Management Involving Endovascular Clamping, Endovascular Replacement, and Open 
      Abdominal Decompression.
PG  - 22-28
LID - 10.3400/avd.oa.16-00110 [doi]
AB  - Objective: Endovascular repair has become the treatment of choice for ruptured 
      abdominal aortic aneurysms (RAAAs). To improve surgical outcomes, preoperative 
      management is important. In 2011, we introduced integrated management, which 
      involves endovascular aneurysm repair, stabilization of hemodynamics by 
      endovascular clamping, and open abdominal decompression to address abdominal 
      compartment syndrome (ACS). Methods: To evaluate the efficacy of this management 
      strategy, 62 patients who had undergone emergency surgery for an RAAA were 
      analyzed retrospectively: group A (n=39), where an old strategy was used, and 
      group B (n=23), where integrated management was introduced. Patient 
      characteristics and 30-day mortality rates were compared between the two groups. 
      Results: The average patient age was 67.7 years and 74.7 years for groups A and 
      B, respectively (P=0.032). Group B patients required more frequent use of 
      vasopressors (P=0.035). Other patient characteristics did not differ between the 
      two groups. The duration of surgery was significantly shorter in group B than in 
      group A (P=0.001). The total amount of transfused blood did not differ between 
      the two groups. No patients showed symptoms of ACS. Early mortality rates were 
      12.8% and 8.7% in groups A and B, respectively. The number of wound infections 
      was significantly fewer in group B than in group A. Conclusion: Although group B 
      patients were significantly older and had a higher rate of vasopressor use, early 
      mortality was improved in both groups. Morbidity was significantly better in 
      group B with respect to the duration of surgery and number of wound infections 
      than in group A.
FAU - Aoki, Chikashi
AU  - Aoki C
AD  - Department of Thoracic and Cardiovascular Surgery, Hirosaki University Graduate 
      School of Medicine, Hirosaki, Aomori, Japan.
FAU - Kondo, Norihiro
AU  - Kondo N
AD  - Department of Thoracic and Cardiovascular Surgery, Hirosaki University Graduate 
      School of Medicine, Hirosaki, Aomori, Japan.
FAU - Saito, Yoshiaki
AU  - Saito Y
AD  - Department of Thoracic and Cardiovascular Surgery, Hirosaki University Graduate 
      School of Medicine, Hirosaki, Aomori, Japan.
FAU - Taniguchi, Satoshi
AU  - Taniguchi S
AD  - Department of Thoracic and Cardiovascular Surgery, Hirosaki University Graduate 
      School of Medicine, Hirosaki, Aomori, Japan.
FAU - Fukuda, Wakako
AU  - Fukuda W
AD  - Department of Thoracic and Cardiovascular Surgery, Hirosaki University Graduate 
      School of Medicine, Hirosaki, Aomori, Japan.
FAU - Daitoku, Kazuyuki
AU  - Daitoku K
AD  - Department of Thoracic and Cardiovascular Surgery, Hirosaki University Graduate 
      School of Medicine, Hirosaki, Aomori, Japan.
FAU - Fukuda, Ikuo
AU  - Fukuda I
AD  - Department of Thoracic and Cardiovascular Surgery, Hirosaki University Graduate 
      School of Medicine, Hirosaki, Aomori, Japan.
LA  - eng
PT  - Journal Article
DEP - 20170331
PL  - Japan
TA  - Ann Vasc Dis
JT  - Annals of vascular diseases
JID - 101471467
PMC - PMC5579800
OTO - NOTNLM
OT  - EVAR
OT  - abdominal compartment syndrome
OT  - endovascular clamp
OT  - ruptured abdominal aortic aneurysm
OT  - shock
EDAT- 2017/10/17 06:00
MHDA- 2017/10/17 06:01
PMCR- 2017/03/24
CRDT- 2017/10/17 06:00
PHST- 2016/10/27 00:00 [received]
PHST- 2017/01/10 00:00 [accepted]
PHST- 2017/10/17 06:00 [entrez]
PHST- 2017/10/17 06:00 [pubmed]
PHST- 2017/10/17 06:01 [medline]
PHST- 2017/03/24 00:00 [pmc-release]
AID - 10.3400/avd.oa.16-00110 [doi]
PST - ppublish
SO  - Ann Vasc Dis. 2017 Mar 24;10(1):22-28. doi: 10.3400/avd.oa.16-00110. Epub 2017 
      Mar 31.