Document Detail


Postoperative fluid collection after hybrid debranching and endovascular repair of thoracoabdominal aortic aneurysms.
MedLine Citation:
PMID:  21802242     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Hybrid thoracic endovascular aneurysm repair (H-TEVAR) to include visceral and renal debranching has emerged as a potential therapeutic option for thoracoabdominal aneurysms (TAAA). This study was performed to characterize the frequently noted development of postoperative fluid collections surrounding the bypass grafts.
METHODS: All patients undergoing H-TEVAR from 2000-2010 (n = 39, 43.6% male) were identified. One hundred thirty-two bypasses were constructed (median 4 per patient) using either polyester (30), thin-walled polytetrafluoroethylene (ePTFE, 100) or saphenous vein (2). Follow-up computed tomography (CT) imaging was routinely performed at 1 and 6 months, and annually thereafter.
RESULTS: Of the 37 patients with one follow-up CT, 20 (54.1%) were found to have fluid collections. The natural history of the 17 patients with collections and further follow-up imaging was variable, with 2 resolving, 6 stable, and 9 enlarging. Two patients with collections developed evidence of graft infection requiring reoperation. Two patients with enlarging sterile collections required evacuation for symptoms. By multivariate analysis, both preoperative creatinine (P = .005) and number of bypasses constructed (P = .04) independently correlated with the development of a fluid collection.
CONCLUSIONS: Postoperative fluid collections following hybrid debranching procedures identified in this series represent a unique complication not previously described. The subsequent clinical course of these fluid collections is variable and ranges from benign to frank graft infection and relate both to patient factors, as well as specific operative strategies. Longer-term studies with more robust numbers of patient numbers are warranted to determine whether this complication may limit the long-term durability of this procedure.
Authors:
Justin Hurie; Himanshu J Patel; Enrique Criado; Jonathan L Eliason; G Michael Deeb; Gilbert R Upchurch
Publication Detail:
Type:  Journal Article     Date:  2011-07-29
Journal Detail:
Title:  Journal of vascular surgery     Volume:  54     ISSN:  1097-6809     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-05     Completed Date:  2012-04-03     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1623-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Society for Vascular Surgery. All rights reserved.
Affiliation:
Department of Surgery, University of Michigan Cardiovascular Center, Ann Arbor, MI 48109-5864, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aortic Aneurysm, Thoracic / complications,  mortality,  therapy*
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation / adverse effects*
Edema / diagnosis,  etiology,  therapy
Endoleak / diagnosis,  etiology*,  therapy
Endovascular Procedures / adverse effects*,  methods
Female
Humans
Male
Middle Aged
Reoperation
Retrospective Studies
Risk Factors
Seroma / diagnosis,  etiology*,  therapy
Treatment Outcome

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


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