Annals of vascular surgery
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We evaluated national outcomes after open repair of abdominal aortic aneurysms (AAAs) with visceral or renal bypass (VRB). ⋯ VRB repair volume decreased per year similarly to open IRA repair volume and may be related to increasing use of endovascular therapy. Mortality after VRB is high and dependent upon age, renal failure, and congestive heart failure. Overall, VRB repair was associated with worsened outcomes; however, this study cannot conclude that avoiding such a repair will improve outcomes. This should be factored into surgical decision making for these patients.
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Multicenter Study
Factors associated with amputation or graft occlusion one year after lower extremity bypass in northern New England.
Optimal patient selection for lower extremity bypass surgery requires surgeons to predict which patients will have durable functional outcomes following revascularization. Therefore, we examined risk factors that predict amputation or graft occlusion within the first year following lower extremity bypass. ⋯ Preoperative risk factors allow surgeons to predict the risk of amputation or graft occlusion following lower extremity bypass and to more precisely inform patients about their operative risk and functional outcomes. Additionally, our model facilitates comparison of risk-adjusted outcomes across our region. We believe quality-improvement measures such as these will allow surgeons to identify best practices and thereby improve outcomes across centers.