دورية أكاديمية
Effect of Chronic Kidney Disease on 30-Day Outcomes in Endovascular Repair of Complex Abdominal Aortic Aneurysm.
| العنوان: | Effect of Chronic Kidney Disease on 30-Day Outcomes in Endovascular Repair of Complex Abdominal Aortic Aneurysm. |
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| المؤلفون: | Li R; The George Washington University School of Medicine and Health Sciences, Washington, DC, USA., Sidawy A; Department of Surgery, The George Washington University Hospital, Washington, DC, USA., Nguyen BN; Department of Surgery, The George Washington University Hospital, Washington, DC, USA. |
| المصدر: | Vascular and endovascular surgery [Vasc Endovascular Surg] 2024 Aug 19, pp. 15385744241276705. Date of Electronic Publication: 2024 Aug 19. |
| Publication Model: | Ahead of Print |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Sage Publications Country of Publication: United States NLM ID: 101136421 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1938-9116 (Electronic) Linking ISSN: 15385744 NLM ISO Abbreviation: Vasc Endovascular Surg Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Thousand Oaks, CA : Sage Publications Original Publication: Glen Head, N.Y. : Westminster Publications, c2002- |
| مستخلص: | Background: Chronic kidney disease (CKD) has been identified as an independent predictor of poorer long-term prognosis after endovascular aneurysm repair (EVAR) for complex abdominal aortic aneurysm (AAA). However, its impact on short-term perioperative outcomes is conflicting, which can be important for preoperative risk stratification. This study aimed to evaluate the 30-day outcomes of patients with CKD following non-ruptured complex EVAR in a national registry. Methods: Patients who had EVAR for complex AAA were identified in ACS-NSQIP targeted database from 2012-2022. Complex AAA included juxtarenal, suprarenal, or pararenal proximal extent, Type IV thoracoabdominal aneurysm, and/or aneurysms treated with Zenith Fenestrated endograft. Exclusion criteria included age<18 years, ruptured AAA, acute intraoperative conversion to open, emergency presentation, and dialysis. Multivariable logistic regression was used to compare 30-day postoperative outcomes of CKD and non-CKD patients, where demographics, baseline characteristics, aneurysm diameter, distant aneurysm extent, anesthesia, and concomitant procedures were adjusted. Results: There were 695 (39.33%) and 1072 (60.67%) patients with and without CKD, respectively, who underwent EVAR for complex AAA. Patients with and without CKD have comparable 30-day mortality (aOR = 1.165, 95 CI = 0.646-2.099, P = 0.61). However, CKD patients had a higher risk of renal complications (aOR = 2.647, 95 CI = 1.399-5.009, P < 0.01) including higher progressive renal insufficiency (aOR = 3.707, 95 CI = 1.329-10.338, P = 0.01) and acute renal failure requiring renal replacement therapy (aOR = 2.533, 95 CI = 1.139-5.633, P = 0.02). All other 30-day outcomes were comparable between CKD and non-CKD patients. Conclusion: Patients with CKD had similar 30-day mortality and morbidity rates but a higher risk of postoperative renal complications. Therefore, meticulous preoperative planning and postoperative management, which may include optimal hydration, appropriate contrast use, and close renal function monitoring, are essential for patients with CKD after complex EVAR. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. |
| فهرسة مساهمة: | Keywords: abdominal aortic aneurysm; chronic kidney disease; endovascular; endovascular aneurysm repair |
| تواريخ الأحداث: | Date Created: 20240819 Latest Revision: 20240819 |
| رمز التحديث: | 20240820 |
| DOI: | 10.1177/15385744241276705 |
| PMID: | 39158964 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1938-9116 |
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| DOI: | 10.1177/15385744241276705 |