Retroperitoneal approach to abdominal aortic aneurysm repair preserves splanchnic perfusion as measured by gastric tonometry.

Background: We investigated if minimizing bowel manipulation and mesenteric traction using the retroperitoneal approach in open abdominal aortic aneurysm (AAA) repair preserves splanchnic perfusion, as measured by gastric tonometry, and reduces the systemic inflammatory response and dysfunction of the various organs.

Methods: Patients undergoing elective AAA repair were randomized into three groups. Group I had repair via the retroperitoneal approach, while groups II and III were repaired via the transperitoneal approach with the bowel packed within the peritoneal cavity or exteriorized in a bowel bag, respectively.

Retroperitoneal repair of abdominal aortic aneurysm reduces bowel dysfunction.

Objective: To assess the effect of intestinal manipulation and mesenteric traction on gastro-intestinal function and postoperative recovery in patients undergoing abdominal aortic aneurysm (AAA) repair.

Methods: Thirty-five patients undergoing AAA repair were randomised into 3 groups. Group I (n = 11) had repair via retroperitoneal approach while Group II (n = 12) and Group III (n = 12) were repaired via transperitoneal approach with bowel packed within the peritoneal cavity or exteriorised in a bowel bag respectively.

Prosthetic stent graft infection after endovascular abdominal aortic aneurysm repair.

Objective: The purpose of this report is to discuss the incidence, diagnosis, and management of stent graft infections after endovascular aneurysm repair (EVAR).

Methods: Data were collected from the hospital database and medical case notes for all patients with infected endografts after elective or emergency EVAR for abdominal aortic aneurysm (AAA) during the last 8 years in two university teaching hospitals in Northern Ireland. The data included the patient's age, gender, presentation of sepsis, treatment offered, and the ultimate outcome.

Successful surgical management of a ruptured true pancreaticoduodenal artery aneurysm following failed transcatheter embolization.

A ruptured splanchnic artery aneurysm is a rare clinical entity. Its diagnosis requires a high index of clinical suspicion, and management usually requires a multidisciplinary approach. We present a case of ruptured true pancreaticoduodenal artery aneurysm in an 83-year-old woman who was initially treated with transcatheter embolization, but it failed to arrest the bleeding, and she subsequently required laparotomy and surgical ligation.

An intention-to-treat by endovascular repair policy may reduce overall mortality in ruptured abdominal aortic aneurysm.

Objective: The use of endovascular aneurysm repair (EVAR) for ruptured abdominal aortic aneurysm (AAA) has been restricted to a small number of specialized units on a selected group of patients. The aim of this study is to assess if the overall mortality in these patients with ruptured AAA may be reduced in a unit where all patients with ruptured AAA are considered first for EVAR.

Methods: During a 24-month period beginning in July 2002, 51 patients admitted with ruptured AAA were considered for EVAR as the treatment of choice and comprised the study group.

Use of proximal aortic cuffs as an adjunctive procedure during endovascular aortic aneurysm repair.

The purpose of this study was to evaluate the incidence and durability of additional proximal cuffs during endovascular abdominal aortic aneurysm repair (EVAR). A retrospective review of 90 EVAR patients was conducted. Postoperative survival, proximal sealing zone-related complications, and secondary procedures were analyzed.

Cytokine activation and intestinal mucosal and renal dysfunction are reduced in endovascular AAA repair compared to surgery.

Purpose: To compare endovascular (EVR) to open repair (OR) of abdominal aortic aneurysm (AAA) for cytokine activation, changes in the intestinal mucosal barrier, and renal dysfunction.

Methods: In a prospective nonrandomized study, 15 patients admitted to a university hospital for elective infrarenal AAA repair (8 OR and 7 EVR) were recruited. Intestinal permeability was assessed preoperatively (PO), at day 1 (D1), and at day 3 (D3) after surgery using the lactulose/mannitol differential excretion (LMR) test.