Document Detail

Does the sequence of clamp application during open abdominal aortic aneurysm surgery influence distal embolisation?
MedLine Citation:
PMID:  14652839     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Embolisation of atherosclerotic debris during abdominal aortic aneurysm (AAA) repair is responsible for significant peri-operative morbidity. Reports have suggested that preferential clamping of the distal vessel(s) before the proximal aorta may decrease the number of emboli passing distally and hence reduce complications. METHODS: Forty patients undergoing AAA repair were randomised to have either first clamping of the proximal aorta or the iliac vessels. Emboli passing through the Superficial Femoral Arteries were detected with a Transcranial Doppler ultrasound system. RESULTS: There was no difference between the two groups in the number of emboli detected (p=0.49) and no significant correlation between number of emboli and dissection time (r=0.0008). However, there was a significantly higher number of emboli in the patient sub-group that were current smokers (p=0.034). CONCLUSIONS: There appears to be no difference in the numbers of emboli detected when the first vascular clamp is applied to the proximal aorta or iliacs.
S E Webster; J Smith; M M Thompson; P R F Bell; A R Naylor
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery     Volume:  27     ISSN:  1078-5884     ISO Abbreviation:  Eur J Vasc Endovasc Surg     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2003-12-03     Completed Date:  2004-01-22     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9512728     Medline TA:  Eur J Vasc Endovasc Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  61-4     Citation Subset:  IM    
Department of Vascular Surgery, Leicester Royal Infirmary, UK.
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MeSH Terms
Aortic Aneurysm, Abdominal / surgery*
Embolism / etiology*
Middle Aged
Surgical Instruments
Vascular Surgical Procedures / adverse effects,  methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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