European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery
-
Eur J Vasc Endovasc Surg · Dec 2007
Review Comparative StudyEndovascular ruptured abdominal aortic aneurysm repair (EVRAR): a systematic review.
To review evidence supporting the use of endovascular ruptured aneurysm repair (EVRAR) for treatment of ruptured abdominal aortic aneurysm (RAAA). ⋯ For the treatment of symptomatic or ruptured abdominal aortic aneurysm, emergency endovascular repair (EVRAR) is feasible in selected patients, with early outcomes comparable to best conventional open surgical repair for the treatment of RAAA.
-
Eur J Vasc Endovasc Surg · Dec 2007
Case ReportsUrgent endovascular covered-stent treatment of internal carotid artery injury caused by a gunshot.
Penetrating non-lethal injuries to the distal extra-cranial internal carotid artery are often a surgical challenge, because of the difficulty of direct exposure and repair of the internal carotid artery at the skull base. We describe a case of a successful emergency treatment, with an endovascular procedure using a PTFE covered-stent, of an internal carotid artery haemorrhagic pseudoaneurysm following penetrating trauma to the neck by single gunshot.
-
Eur J Vasc Endovasc Surg · Nov 2007
Comparative StudyComparison of risk-scoring methods in predicting the immediate outcome after elective open abdominal aortic aneurysm surgery.
The aim of this study was to apply three simple risk - scoring systems to prospectively collected data on all elective open Abdominal Aortic Aneurysm (AAA) operations in the Cambridge Academic Vascular Unit over a 6 - year period (January 1998 to January 2004), to compare their predictive values and to evaluate their validity with respect to prediction of mortality and post-operative complications. ⋯ All three scoring systems accurately predicted the risk of mortality and morbidity in patients undergoing elective open AAA repair. Among these, E-PASS seemed to be the most accurate predictor in this patient population.
-
This study evaluated the Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM), Portsmouth (P) POSSUM and Vascular (V) POSSUM. The primary aim was to assess the validity of these scoring systems in a population of patients undergoing elective and emergency open AAA repair. The secondary intention was in the event that these equations did not fit all patients with an aneurysm; a new model would be developed and tested using logistic regression from the local data (Cambridge POSSUM). ⋯ POSSUM, V-POSSUM and P-POSSUM may not be robust tools for comparing mortality between populations undergoing elective and emergency open AAA repair as once thought. The development and successful validation of Cambridge POSSUM provides a unified model to describe both elective and emergency AAAs together and should be validated in other geographical settings.
-
Eur J Vasc Endovasc Surg · Nov 2007
Positive fluid balance is associated with complications after elective open infrarenal abdominal aortic aneurysm repair.
Open abdominal aortic aneurysm (AAA) repair is associated with cardiac and respiratory complications and an overall mortality rate of 2 to 8%. We hypothesised that excessive fluid administration during the perioperative period contributes to complications and poor outcome after AAA repair. ⋯ Serious complications are common after elective open AAA repair, and we have shown that positive fluid balance is predictive of major adverse events increased HDU/ICU and overall hospital stay.