Document Detail


Suprarenal clamping is a safe method of aortic control when infrarenal clamping is not desirable.
MedLine Citation:
PMID:  18538980     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We evaluated the safety of suprarenal aortic clamping in patients with abdominal aortic aneurysm (AAA) treated by open aortic replacement by retrospectively reviewing all patients who underwent elective AAA replacement at a university hospital from 1993 until 2003. We reviewed 249 patient charts and divided them into three groups according to the clamp location during aortic replacement: group 1, infrarenal clamp group (n = 185); group 2, suprarenal clamp group (n = 52); and group 3, supraceliac clamp group (n = 12). Groups 1 and 2 were compared with respect to risk factors, intraoperative events, and postoperative events. Statistical analysis was done using Wilcoxon's rank-sum test, chi-squared test, and Fisher's exact test. Risk factors were comparable in groups 1 and 2 except for weight, which was higher in group 1. Intraoperative urine output, hypotensive episodes, and use of renal protective drugs were comparable in the two groups. Operation time, blood loss, and use of IV fluids were all significantly higher in group 2, while total aortic clamp time was higher in group 1. Postoperative events were comparable except for postoperative peak creatinine, intensive care unit length of stay, and postoperative length of stay, which were higher in group 2; however, discharge creatinine was comparable without a significant difference. Suprarenal clamping is a safe method of aortic control during open AAA replacement surgery. The selection of clamping site should be individualized according to the intraoperative anatomy. Supraceliac clamping is not necessarily the preferable method of aortic control when the infrarenal location is not suitable for clamping.
Authors:
W John Sharp; Mohammad Bashir; Ronnie Word; Rachael Nicholson; Christopher Bunch; John Corson; Timothy Kresowik; Jamal Hoballah
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-06-06
Journal Detail:
Title:  Annals of vascular surgery     Volume:  22     ISSN:  1615-5947     ISO Abbreviation:  Ann Vasc Surg     Publication Date:    2008 Jul-Aug
Date Detail:
Created Date:  2008-07-14     Completed Date:  2008-09-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8703941     Medline TA:  Ann Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  534-40     Citation Subset:  IM    
Affiliation:
Department of Vascular Surgery, University of Iowa, Iowa City, IA 52242, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aorta, Abdominal / surgery*
Aortic Aneurysm, Abdominal / surgery*
Blood Vessel Prosthesis Implantation
Constriction
Female
Humans
Intraoperative Complications
Kidney Failure / etiology
Male
Vascular Surgical Procedures / adverse effects

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


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