scholarly journals Monitored Anesthesia Care Without Foley Placement Decreases Hospital Length of Stay in Elective Endovascular Abdominal Aortic Aneurysm Repair

2021 ◽  
Vol 74 (4) ◽  
pp. e416-e417
Author(s):  
Shruthi M. Nammalwar ◽  
Daniel G. Miles ◽  
Cassra Arbabi ◽  
Rameen Moridzadeh ◽  
Ryan Abdul-Haqq ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Abdominal Aortic Aneurysm Repair ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Anesthesia Care ◽  
Monitored Anesthesia Care ◽  
Abdominal Aortic ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair

scholarly journals Factors Associated with Wound Complications after Open Femoral Artery Exposure for Elective Endovascular Abdominal Aortic Aneurysm Repair

2019 ◽  
Vol 28 (02) ◽  
pp. 124-129 ◽  
Author(s):  
Bradley Trinidad ◽  
Denis Rybin ◽  
Gheorghe Doros ◽  
Mohammad Eslami ◽  
Tze-Woei Tan
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Abdominal Aortic Aneurysm Repair ◽  
Hospital Length Of Stay ◽  
Wound Complications ◽  
Study Cohort ◽  
Improvement Program ◽  
Abdominal Aortic ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair

We identified factors that would lead to wound complications after open femoral exposure for endovascular abdominal aortic aneurysm repair (oEVAR).Using the National Surgical Quality Improvement Program dataset (2005–2014), we examined the patients who underwent oEVAR. Patients were stratified on whether they developed postoperative wound complications. Comparisons were made between group with wound complications and those without and adjusted analyses performed to identify variables that independently increased the risk of wound complications.There were 14,868 patients in the study cohort and 2.6% (384 patients) developed wound complications after EVAR. Among those with wound complications, 94% (360 patients) of patients had superficial and deep surgical site infection. Patients who had wound complication were likely to be younger (72.6 vs. 73.7 years old (p = 0.02), functionally dependent (5.4 vs. 2.5%) (p < 0.05), smoker (3 vs. 2.4%, p =0.03), female (4 vs. 2.2%), with significantly higher body mass index (31 vs. 28), and more commonly had diabetes (4 vs. 2.4%, p < 0.001) or renal failure (12 vs. 3%, p < 0.001). Although perioperative survival was similar, patients who had wound complications had significantly longer hospital length of stay (LOS) (7.3 ± 12 vs. 3.4 ± 5 days, p < 0.001).Up to 3% patients developed wound complications after open femoral exposure during EVAR with significantly higher LOS and therefore cost utilization.

Percutaneous endovascular abdominal aortic aneurysm repair with monitored anesthesia care decreases operative time but not pulmonary complications

Vascular ◽  
2021 ◽  
pp. 170853812110129
Author(s):  
Joshua P Kronenfeld ◽  
Emily L Ryon ◽  
Alex Lall ◽  
Naixin Kang ◽  
Stefan Kenel-Pierre ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Operating Room ◽  
Operative Time ◽  
Abdominal Aortic Aneurysm Repair ◽  
Pulmonary Complications ◽  
Anesthesia Care ◽  
Monitored Anesthesia Care ◽  
Abdominal Aortic ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair

Objectives To report our experience and compare the results of percutaneous endovascular aortic aneurysm repair (PEVAR) performed under monitored anesthesia care (MAC) to PEVAR under general anesthesia (GA). Methods A retrospective review of patients who underwent non-emergency endovascular abdominal aortic aneurysm repair (EVAR) was completed. Patients were excluded if they had a complex repair, including fenestrated, branched, or parallel endografting. Demographics, operative data, 30-day mortality/morbidity and postoperative outcomes were analyzed. Results A total of 159 patients were identified with a median age of 69. 115 patients had PEVAR, 45 (39.1%) PEVAR MAC and 70 (60.9%) PEVAR GA. PEVAR MAC compared to PEVAR GA had decreased operative time (106 vs. 134 min, P < 0.001), time in the operating room (163 vs. 245 min, P = 0.016), and estimated blood loss (EBL) (115 vs. 176 mL P = 0.012). There was no statistically significant difference in the hospital length of stay (LOS) (1.9 vs. 2.7 days, P = 0.133), and post-operative complications including pulmonary (2.2 vs. 2.9%, P = 0.835). Forty-four patients had EVAR with a femoral cutdown (FC), including 14 PEVAR conversions. PEVAR conversion was associated with higher EBL (543 vs. 323 mL, P = 0.03), operative time (230 vs. 178 min, P = 0.01), and operating room time (307 vs. 275 min, P = 0.01) compared to planned EVAR with FC. Conclusions PEVAR under MAC is associated with shorter time in the operating room compared to PEVAR under GA. PEVAR under MAC does however not decrease overall morbidities, including postoperative pulmonary complications.

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