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. 2022 Oct 1;12(10):1630.
doi: 10.3390/jpm12101630.

Long-Term Results of Complex Abdominal Aortic Aneurysm Open Repair

Yamume Tshomba  1 , Simona Sica  1 , Fabrizio Minelli  1 , Marco Ferraresi  2 , Chiara de Waure  3 , Tommaso Donati  1 , Francesca De Nigris  1 , Claudio Vincenzoni  1 , Francesco Snider  1 , Giovanni Tinelli  1
Affiliations

Long-Term Results of Complex Abdominal Aortic Aneurysm Open Repair

Yamume Tshomba et al. J Pers Med. .

Abstract

This study investigated the long-term outcomes of patients treated with open surgical repair for complex abdominal aortic aneurysms (c-AAAs). A total of 119 patients with c-AAAs undergoing repair between January 2010 and June 2016 in a high-volume aortic center were included. The long-term imaging follow-up consisted of yearly abdominal ultrasound examinations and 5-year computed tomography angiography. At a median follow-up of 76 months (IQR 38 months), forty-three deaths (37%) and three (2.5%) aortic-related deaths were observed. Long-term chronic renal decline was observed in fifty (43.8%) patients, significantly correlated with post-operative acute kidney injury. During the follow-up, five reinterventions (4.3%) were performed. The present study suggests that open c-AAA repair can be performed with acceptable operative risk with durable results. To achieve the best possible long-term outcome, the open surgery repair of complex AAA should be performed in high-volume aortic centers and tailored to the patient.

Keywords: complex abdominal aortic aneurysm; open surgery; pararenal; paravisceral; personalized medicine; renal decline.

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Conflict of interest statement

Giovanni Tinelli: Consultant for Medtronic and Terumo Aortic; Fabrizio Minelli: None; Simona Sica: None; Marco Ferraresi: None; Chiara de Waure: None; Tommaso Donati: None; Claudio Vincenzoni: None; Francesco Snider: None; Yamume Tshomba: Consultant for Medtronic and Terumo Aortic.

Figures

Figure 1
Figure 1
Intraoperative details of the reconstruction strategies: Proximal beveled anastomosis including the renal artery (A); direct renal reattachment to the aortic graft (B); bilateral aorto-renal bypass (C).
Figure 2
Figure 2
Kaplan–Meier analysis of freedom from chronic renal decline in patients with AKI vs. patients without AKI.
Figure 3
Figure 3
Kaplan–Meier analysis of freedom from chronic renal decline of patients without AKI vs. with AKI with and without recovery of renal function at discharge.
See this image and copyright information in PMC

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