초록접수 현황
| 19F-082 | 구연 발표 |
Clinical Outcome of Surgical Repair with Composite Prosthetic Graft for Abdominal Aortic Aneurysm Accompanied by Iliac Artery Aneurysm
Bongyeon Sohn, Hakju Kim, Hyoung Woo Chang, Jae Hang Lee, Dong Jung Kim, Jun Sung Kim, Cheong Lim, Kay-Hyun Park
Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Gyeonggi-do, Republic of Korea
Purpose : In the era of endovascular repair, concomitant iliac artery aneurysm is found frequently in patients undergoing surgical repair of abdominal aortic aneurysm (AAA). As aggressive resection of dilated iliac arteries and hand-made composite grafting has been the procedure of choice in our center, we aimed to evaluate the efficacy of such procedure.
Methods : A total of 233 patients (mean age 71.5±10.3 years, ruptured aneurysm in 57 patients) underwent open surgery for AAA from 2003 through July 2019; 155 patients (67%) with conventional straight or bifurcated graft and 78 patients (33%) with composite graft. The operative characteristics, postoperative outcome variables, postoperative CT images were retrospectively reviewed.
Results : The early mortality rate was not different between two groups; conventional 0.9% vs composite 0% after elective surgery and 21% vs 14% after emergency surgery. The composite graft technique took longer by 15 minutes (199.2±63.1 vs 215.9±42.7, p<0.05). There was no difference in the major outcomes; red blood cell transfusion (mean 2.8±4.7 units vs 3.1±4.7 units, p=0.680), reoperation for bleeding (2.7% vs 3.1%), bowel ischemia (0% vs 1.6%, p=0.364), intensive care unit stay (1.9±6.6 days vs 1.6±2.4 days) and hospital stay (14.9±14.7 days vs 15.1±12.1 days) in case of elective surgery. The incidence of target vessel (iliac arteries) occlusion did not differ, either.
Conclusion : The increased technical demand of composite grafting did not impose a negative impact on the outcome of AAA repair. Such technique may be considered an alternative to the conventional repair using aortofemoral bypass and obliteration of the dilated iliac artery.
Methods : A total of 233 patients (mean age 71.5±10.3 years, ruptured aneurysm in 57 patients) underwent open surgery for AAA from 2003 through July 2019; 155 patients (67%) with conventional straight or bifurcated graft and 78 patients (33%) with composite graft. The operative characteristics, postoperative outcome variables, postoperative CT images were retrospectively reviewed.
Results : The early mortality rate was not different between two groups; conventional 0.9% vs composite 0% after elective surgery and 21% vs 14% after emergency surgery. The composite graft technique took longer by 15 minutes (199.2±63.1 vs 215.9±42.7, p<0.05). There was no difference in the major outcomes; red blood cell transfusion (mean 2.8±4.7 units vs 3.1±4.7 units, p=0.680), reoperation for bleeding (2.7% vs 3.1%), bowel ischemia (0% vs 1.6%, p=0.364), intensive care unit stay (1.9±6.6 days vs 1.6±2.4 days) and hospital stay (14.9±14.7 days vs 15.1±12.1 days) in case of elective surgery. The incidence of target vessel (iliac arteries) occlusion did not differ, either.
Conclusion : The increased technical demand of composite grafting did not impose a negative impact on the outcome of AAA repair. Such technique may be considered an alternative to the conventional repair using aortofemoral bypass and obliteration of the dilated iliac artery.
첨부파일 : 2019_추계_AAA-final.pptx
책임저자: Kay-Hyun Park
Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Gyeonggi-do, Republic of Korea
발표자: Bongyeon Sohn, E-mail : s.bongyeon@gmail.com