Journal of vascular surgery
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Previous studies have shown that female gender is associated with increased morbidity and mortality after endovascular abdominal aortic aneurysm repair. The goal of this study was to assess the effect of gender on 30-day outcomes after thoracic endovascular aortic aneurysm repair (TEVAR) using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. ⋯ Thirty-day unadjusted mortality after TEVAR for nonruptured thoracic aortic aneurysms is increased in women compared with men, but this univariate finding did not persist after risk adjustment. Multivariable analysis showed need for iliac artery exposure, age, and emergency surgery were independently associated with higher mortality rates. These results suggest a need for decreased device delivery size and improvements in endovascular technology.
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Percutaneous endovascular abdominal aortic aneurysm repair (PEVAR) has been associated with fewer groin wound complications and shorter operative times, but same-day discharge (SDD) has not been reported. The goal of our article is to assess the feasibility and safety of ambulatory PEVAR and identify patient characteristics that are eligible for this approach. ⋯ Ambulatory PEVAR was found to be feasible and safe in one-third of patients undergoing elective EVAR who did not have excessive medical risk, had good functional capacity, and underwent an uneventful procedure. The impact of SDD on cost-effectiveness needs to be further assessed and may not be feasible in hospitals reimbursed based on admission status.
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Iatrogenic migration of inferior vena cava (IVC) filters is a potentially life-threatening complication that can arise during blind insertion of central venous catheters when the guide wire becomes entangled with the filter. In this study, we reviewed the occurrence of iatrogenic migration of IVC filters in the literature and assessed methods for preventing this complication. ⋯ Iatrogenic migration of an IVC filter is an uncommon complication related to wire/filter entrapment. This complication can be prevented with knowledge of the patient's history, use of proper techniques when placing a central venous catheter, identification of wire entrapment at an early stage, and use of an appropriate technique to disengage an entrapped wire.