Perioperative Haemorrhage in Endovascular Abdominal Aneurysm Repair Affects Outcome

Objective This study aimed to evaluate the outcome and predisposing factors related to perioperative bleeding in patients treated with endovascular aneurysm repair (EVAR) for ruptured and non-ruptured abdominal aortic aneurysm (AAA). Design This was a retrospective cohort study. Methods A total of 5...

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Bibliographic Details
Published in:European journal of vascular and endovascular surgery 2013-07, Vol.46 (1), p.87-92
Main Authors: Montán, C, Wannberg, M, Holst, J, Wahlgren, C.M
Format: Article
Language:English
Subjects:
Abdominal aortic aneurysm
Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal - surgery
Blood Loss, Surgical - statistics & numerical data
Causality
Clinical Medicine
Cohort Studies
Endovascular aneurysm repair
Endovascular Procedures
EVAR
Female
Humans
Kirurgi
Klinisk medicin
Male
Medical and Health Sciences
Medicin och hälsovetenskap
Middle Aged
Mortality
Perioperative bleeding
Postoperative complications
Postoperative Hemorrhage - epidemiology
Retrospective Studies
Surgery
Treatment Outcome
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Summary:Objective This study aimed to evaluate the outcome and predisposing factors related to perioperative bleeding in patients treated with endovascular aneurysm repair (EVAR) for ruptured and non-ruptured abdominal aortic aneurysm (AAA). Design This was a retrospective cohort study. Methods A total of 525 consecutive patients (73% elective) with AAA underwent EVAR at two vascular centres from 2008 to 2011. From registry data perioperative bleeding was analysed in relation to outcome and preoperative data. Results A total of 453 (86%) patients presented with a perioperative bleeding 5000 ml. Other than ruptured AAA ( n  = 90), no preoperative risk factors for increased perioperative bleeding were found. Open femoral artery access ( n  = 101), branched ( n  = 18) and uni-iliacal endografts ( n  = 18) and introducer size were associated with increased perioperative bleeding ( P  2000 ml were significantly related to 30-day mortality (odds ratio 10.6 (range 3.8–29.6) and 13.4 (range 4.8–37.4), respectively). Postoperative renal failure, multi-organ failure, >5 days at intensive care unit, bowel ischaemia and abdominal compartments syndrome were significantly related to perioperative bleeding >2000 ml ( P  
ISSN:1078-5884
1532-2165
1532-2165
DOI:10.1016/j.ejvs.2013.02.011