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European Journal of Vascular and... Jan 2011Small aneurysms of the abdominal aorta (3.0-5.5 cm in diameter) often are managed by regular surveillance, rather than surgery, because the risk of surgery is considered... (Review)
Review
BACKGROUND
Small aneurysms of the abdominal aorta (3.0-5.5 cm in diameter) often are managed by regular surveillance, rather than surgery, because the risk of surgery is considered to outweigh the risk of aneurysm rupture. The risk of small aneurysm rupture is considered to be low. The purpose of this review is to summarise the reported estimates of small aneurysm rupture rates.
METHODS AND FINDINGS
We conducted a systematic review of the literature published before 2010 and identified 54 potentially eligible reports. Detailed review of these studies showed that both ascertainment of rupture, patient follow-up and causes of death were poorly reported: diagnostic criteria for rupture were never reported. There were only 14 studies from which rupture rates (as ruptures per 100 person-years) were available. These 14 published studies included 9779 patients (89% male) over the time period 1976-2006 but only 7 of these studies provided rupture rates specifically for the diameter range 3.0-5.5 cm, which ranged from 0 to 1.61 ruptures per 100 person-years.
CONCLUSIONS
Rupture rates of small abdominal aortic aneurysms would appear to be low, but most studies have been poorly reported and did not have clear ascertainment and diagnostic criteria for aneurysm rupture.
Topics: Aortic Aneurysm, Abdominal; Aortic Rupture; Humans; Research Design; Risk Assessment
PubMed: 20952216
DOI: 10.1016/j.ejvs.2010.09.005 -
Journal of Shoulder and Elbow Surgery Mar 2012Reported descriptions of pectoralis major (PM) injury are often inconsistent with the actual musculotendinous morphology. The literature lacks an injury classification... (Review)
Review
BACKGROUND
Reported descriptions of pectoralis major (PM) injury are often inconsistent with the actual musculotendinous morphology. The literature lacks an injury classification system that is consistently applied and accurately reflects surgically relevant anatomic injury patterns, making meaningful comparison of treatment techniques and outcomes difficult.
MATERIALS AND METHODS
Published cases of PM injury between 1822 and 2010 were analyzed to identify incidence and injury patterns and the extent to which these injuries fit into a classification category. Recent work outlining the 3-dimensional anatomy of the PM muscle and tendon, as well as biomechanical studies of PM muscle segments, were reviewed to identify the aspects of musculotendinous anatomy that are clinically and surgically relevant to injury classification.
RESULTS
We identified 365 cases of PM injury, with 75% occurring in the last 20 years; of these, 83% were a result of indirect trauma, with 48% occurring during weight-training activities. Injury patterns were not classified in any consistent way in timing, location, or tear extent, particularly with regard to affected muscle segments contributing to the PM's bilaminar tendon.
CONCLUSIONS
A contemporary injury classification system is proposed that includes (1) injury timing (acute vs chronic), (2) injury location (at the muscle origin or muscle belly, at or between the musculotendinous junction and the tendinous insertion, or bony avulsion), and (3) standardized terminology addressing tear extent (anterior-to-posterior thickness and complete vs incomplete width) to more accurately reflect the musculotendinous morphology of PM injuries and better inform surgical management, rehabilitation, and research.
Topics: Adult; Aged; Aged, 80 and over; Female; Humans; Injury Severity Score; Lacerations; Male; Middle Aged; Orthopedic Procedures; Pectoralis Muscles; Prognosis; Risk Assessment; Rupture; Tendon Injuries; Treatment Outcome
PubMed: 21831661
DOI: 10.1016/j.jse.2011.04.035 -
Arthroscopy : the Journal of... Jul 2022The purpose of this study is to compare the biomechanical properties between traditional transosseous tunnel and suture anchor technique repair for extensor mechanism... (Review)
Review
PURPOSE
The purpose of this study is to compare the biomechanical properties between traditional transosseous tunnel and suture anchor technique repair for extensor mechanism ruptures and assess for differences in the mechanism of failure of both techniques.
METHODS
A multi-database search (PubMed, EMBASE, and Medline) was performed according to PRISMA guidelines on November 14, 2021. All articles comparing biomechanical properties of transpatellar and suture anchor technique for extensor mechanism ruptures were included. Abstracts, reviews, case reports, studies without biomechanical analysis, conference proceedings, and non-English language studies were excluded. Outcomes pursued included gap formation, load to failure, and mechanism of failure. Relevant data from studies meeting inclusion criteria were extracted and analyzed. Study methodology was assessed using the Methodological Index for Non-Randomized Studies score.
RESULTS
A total of 212 knees were biomechanically assessed, including 98 patella and 114 quadricep tendon ruptures. Five patellar tendon studies were included, and all of them reported significantly smaller gap formation in suture anchor group. Gap formation for suture anchors ranged from .9 mm to 4.1 mm, while that of transpatellar group ranged from 2.9 mm to 10.3 mm. One study reported a significantly higher load to failure in the suture anchor group, while the remaining four studies reported no significant difference. Load to failure for suture anchor ranged from 259 N to 779 N, while that of the transpatellar group ranged from 287 N to 763 N. The most common mechanism of failure was anchor pullout in suture anchor and knot failure in the transpatellar group. Five quadriceps tendon studies were included, and three studies reported statistically significant smaller gap formation in the suture anchor group. Gap formation for suture anchor ranged from 1.5 mm to 5.0 mm, while that of transpatellar group ranged from 3.1 mm to 33.3 mm. Two studies reported a significantly higher load to failure in the suture anchor group, while one study reported a higher load to failure in the transpatellar repair group. Load to failure for suture anchor ranged from 286 N to 740 N, while that of transpatellar group ranged from 251 N to 691 N. The most common mechanism of failure was suture failure in the suture anchor and knot failure in the transpatellar group.
CONCLUSION
Suture anchor fixation displays a better biomechanical profile than traditional transpatellar techniques in terms of smaller gap formations in the repair of both patella and quadriceps tendon injuries. Anchor pullout in suture anchor fixation was present mainly with the use of titanium anchors.
CLINICAL RELEVANCE
These findings above may result in better retention of tendon approximation in patella and quadriceps tendon fixation postoperatively, which may result in earlier recovery. Further randomized controlled clinical trials to compare these techniques are required.
Topics: Biomechanical Phenomena; Cadaver; Humans; Patella; Rupture; Suture Anchors; Suture Techniques; Sutures; Tendon Injuries; Tendons
PubMed: 35066110
DOI: 10.1016/j.arthro.2022.01.012 -
Journal of Shoulder and Elbow Surgery Apr 2022Ruptures of the distal biceps tendon are most commonly due to traumatic eccentric loading in the middle-aged male population and can result in functional deficits.... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND AND HYPOTHESIS
Ruptures of the distal biceps tendon are most commonly due to traumatic eccentric loading in the middle-aged male population and can result in functional deficits. Although surgical repair has been demonstrated to result in excellent outcomes, there are few comparative studies that show clear functional benefits over nonoperative management. The aim of this systematic review and meta-analysis is to compare the functional outcomes of operative and nonoperative management for these injuries. We hypothesized that operative treatment would be associated with significantly superior outcomes.
METHODS
According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic review of the literature was performed using MEDLINE, SPORTDiscus, CINAHL (Cumulative Index to Nursing and Allied Health Literature), CENTRAL (Cochrane Central Registry of Controlled Trials), Embase, and Web of Science databases. Outcomes of interest included range of motion (ROM), strength, endurance, and patient-reported outcomes including Disabilities of the Arm, Shoulder and Hand (DASH), Mayo Elbow Performance Score (MEPS), and visual analog scale (VAS) for pain scores. Summary effect estimates of the mean difference between operative and nonoperative management for each outcome were estimated in mixed effects models.
RESULTS
Of an initially identified 6478 studies, 62 reported outcomes for a total of 2481 cases (2402 operative, 79 nonoperative), with an overall average age of 47.4 years (47.3 for operative, 50.3 for nonoperative). There were 2273 (98.5%) males and 35 (1.5%) females among operative cases, whereas all 79 (100%) nonoperative cases were males. Operative management was associated with a significantly higher flexion strength (mean difference, 25.67%; P < .0001), supination strength (mean difference, 27.56%; P < .0001), flexion endurance (mean difference, 11.12%; P = .0268), and supination endurance (mean difference, 33.86%; P < .0001). Patient-reported DASH and MEPS were also significantly superior in patients who underwent surgical repair, with mean differences of -7.81 (P < .0001) and 7.41 (P = .0224), respectively. Comparative analyses for ROM and pain VAS were not performed because of limited reporting in the literature for nonoperative management.
CONCLUSION
This study represents the first systematic review and meta-analysis to compare functional and clinical outcomes following operative and nonoperative treatment of distal biceps tendon ruptures. Operative treatment resulted in superior elbow and forearm strength and endurance, as well as superior DASH and MEPS.
Topics: Arm; Female; Humans; Male; Middle Aged; Range of Motion, Articular; Rupture; Supination; Tendon Injuries; Treatment Outcome
PubMed: 34999236
DOI: 10.1016/j.jse.2021.12.001 -
The American Journal of Sports Medicine Jun 2018Although simple end-to-end repair of the Achilles tendon is common, many augmented repair protocols have been implemented for acute Achilles tendon rupture. However,... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Although simple end-to-end repair of the Achilles tendon is common, many augmented repair protocols have been implemented for acute Achilles tendon rupture. However, whether augmented repair is better than nonaugmented repair of an acute Achilles tendon rupture is still unknown.
PURPOSE
To conduct a meta-analysis to determine whether augmented surgical repair of an acute Achilles tendon rupture improved subjective patient satisfaction without an increase in rerupture rates. Secondary outcomes assessed included infections, ankle range of motion, calf muscle strength, and minor complications.
STUDY DESIGN
Meta-analysis.
METHODS
A systematic literature search of peer-reviewed articles was conducted to identify all randomized controlled trials (RCTs) comparing augmented repair and nonaugmented repair for acute Achilles tendon rupture from January 1980 to August 2016 in the electronic databases of PubMed, Web of Science (SCI-E/SSCI/A&HCI), and EMBASE. The keywords (Achilles tendon rupture) AND (surg* OR operat* OR repair* OR augment* OR non-augment* OR end-to-end OR sutur*) were combined, and results were limited to human RCTs and controlled clinical trials published in the English language. Four RCTs involving 169 participants were eligible for inclusion; 83 participants were treated with augmented repair and 86 were treated with nonaugmented repair.
RESULTS
Augmented repair led to similar responses when compared with nonaugmented repair for acute Achilles tendon rupture (93% vs 90%, respectively; P = .53). The rerupture rates showed no significant difference for augmented versus nonaugmented repair (7.2% vs 9.3%, respectively; P = .69). No differences in superficial and deep infections occurred in augmented (7 infections) and nonaugmented (8 infections) repair groups during postoperative follow-up ( P = .89). The average incisional infection rate was 8.4% with augmented repair and 9.3% with nonaugmented repair. No significant differences in other complications were found between augmented (7.2%) and nonaugmented (8.1%) repair ( P = .80).
CONCLUSION
Augmented repair, when compared with nonaugmented repair, was not found to improve patient satisfaction or reduce rerupture rate or infection rate. These conclusions are based on 4 trials with small sample sizes, and larger randomized trials are required to confirm these results.
Topics: Achilles Tendon; Humans; Muscle Strength; Patient Satisfaction; Postoperative Period; Randomized Controlled Trials as Topic; Range of Motion, Articular; Plastic Surgery Procedures; Rupture; Surgical Wound Infection; Tendon Injuries; Treatment Outcome
PubMed: 28467100
DOI: 10.1177/0363546517702872 -
Journal of Endovascular Therapy : An... Aug 2014To quantitatively summarize the incidence of misdiagnosis of ruptured abdominal aortic aneurysms (rAAA), the most common presenting features, and the commonest incorrect... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
To quantitatively summarize the incidence of misdiagnosis of ruptured abdominal aortic aneurysms (rAAA), the most common presenting features, and the commonest incorrect differential diagnoses.
METHODS
A systematic search according to PRISMA guidelines was performed using EMBASE and MEDLINE databases to identify studies reporting the initial rate of misdiagnosis of patients with rAAA. Random-effects meta-analyses were performed to estimate the rate of misdiagnosis, presenting features, and commonest differential diagnoses. A sensitivity analysis was performed for studies reporting after 1990.
RESULTS
Nine studies comprising 1109 patients contributed to the pooled analysis, which found a 42% incidence of rAAA misdiagnosis (95% CI 29% to 55%). In studies reporting after 1990, misdiagnosis was seen in 32% (95% CI 16% to 49%). The most common erroneous differential diagnoses were ureteric colic and myocardial infarction. Abdominal pain, shock, and a pulsatile mass were presenting features in 61% (49%-72%), 46% (32%-61%), and 45% (29%-62%) of rAAAs, respectively.
CONCLUSION
The rate of misdiagnosis of rAAA has remained consistent over time and is concerning. There is a need for an effective clinical decision tool to enable accurate diagnosis and triage at the scene of the emergency.
Topics: Aortic Aneurysm, Abdominal; Aortic Rupture; Diagnosis, Differential; Diagnostic Errors; Humans; Predictive Value of Tests; Prognosis
PubMed: 25101588
DOI: 10.1583/13-4626MR.1 -
The American Journal of Sports Medicine Apr 2024Approximately 90% of patients who undergo arthroscopic rotator cuff repair (RCR) are satisfied with their pain levels and function after surgery. However, a subset of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Approximately 90% of patients who undergo arthroscopic rotator cuff repair (RCR) are satisfied with their pain levels and function after surgery. However, a subset of patients experience continued symptoms that warrant revision surgery. Preoperative risk factors for RCR failure requiring revision surgery have not been clearly defined.
PURPOSE
To (1) determine the rate of RCR failure requiring revision surgery and (2) identify risk factors for revision surgery, which will help surgeons to determine patients who are at the greatest risk for RCR failure.
STUDY DESIGN
Systematic review and meta-analysis; Level of evidence, 4.
METHODS
A systematic review and meta-analysis in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were performed. The initial search resulted in 3158 titles, and 533 full-text articles were assessed for eligibility. A total of 10 studies met the following inclusion criteria: (1) human clinical studies, (2) arthroscopic RCR, (3) original clinical research, and (4) evaluation of preoperative risk factors for revision.
RESULTS
After a full-text review, a total of 16 risk factors were recorded and analyzed across 10 studies. Corticosteroid injection was the most consistent risk factor for revision surgery, reaching statistical significance in 4 of 4 studies, followed by workers' compensation status (2/3 studies). Patients with corticosteroid injections had a pooled increased risk of revision surgery by 47% (odds ratio, 1.44 [95% CI, 1.36-1.52]). Patients with workers' compensation had a pooled increased risk of revision surgery by 133% (odds ratio, 2.33 [95% CI, 2.09-2.60]). Age, smoking status, diabetes, and obesity were found to be risk factors in half of the analyzed studies.
CONCLUSION
Corticosteroid injections, regardless of the frequency of injections, and workers' compensation status were found to be significant risk factors across the literature based on qualitative analysis and pooled analysis. Surgeons should determine ideal candidates for arthroscopic RCR by accounting for corticosteroid injection history, regardless of the frequency, and insurance status of the patient.
Topics: Humans; Rotator Cuff; Rotator Cuff Injuries; Reoperation; Incidence; Adrenal Cortex Hormones; Risk Factors; Arthroscopy; Treatment Outcome
PubMed: 38251854
DOI: 10.1177/03635465231182993 -
JBJS Reviews Sep 2014A number of reports have been published on the effectiveness and design of intervention programs for the prevention of rupture of the anterior cruciate ligament (ACL) in... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
A number of reports have been published on the effectiveness and design of intervention programs for the prevention of rupture of the anterior cruciate ligament (ACL) in female athletes. The purpose of this study was to systematically review the literature to determine the effectiveness of neuromuscular training programs in preventing ACL injury in female athletes.
METHODS
A systematic review was performed with use of the PubMed, MEDLINE, Embase, and Cochrane Central Register of Controlled Trials databases. The search terms included "anterior cruciate ligament" and "ACL" combined with "prevention" and "intervention." The searches included material indexed by September 30, 2013. Data concerning study design, the characteristics of participants, the details of the neuromuscular programs, the types of sports, and number of ACL ruptures were extracted from the studies. Study heterogeneity was assessed with funnel plot and Egger regression methods. Pooled effects were calculated with use of a DerSimonian-Laird random-effects model. The number needed to treat was calculated on the basis of pooled incidence data.
RESULTS
The risk of ACL rupture was 1.83 times higher for female athletes who did not participate in neuromuscular ACL-prevention training programs (odds ratio [OR], 1.83; 95% confidence interval [95% CI], 1.08 to 3.10; p = 0.02). In studies that focused exclusively on soccer, the risk of ACL rupture was 2.62 times higher for nonparticipating athletes (OR, 2.62; 95% CI, 1.59 to 4.32; p < 0.01). When the data were analyzed according to the timing of the intervention, no significant effects were found. In studies in which the program took place both preseason and in-season, the risk (odds ratio) of ACL rupture for nonparticipating athletes was 2.34 (95% CI, 0.82 to 6.7; p = 0.11). In studies in which the intervention took place in-season only, the risk (odds ratio) of ACL rupture for nonparticipating athletes was 1.25 (95% CI, 0.23 to 6.75; p = 0.8). The number needed to treat to prevent a single ACL rupture was 128.7 athletes. We found no significant heterogeneity among the included studies. The I value was 35.40% (p = 0.11). No significant publication bias was found in our included studies.
CONCLUSIONS
The results of this systematic review and meta-analysis favor a protective effect of neuromuscular training programs on the risk of ACL rupture in female athletes. This protective effect is more pronounced in soccer players. Additional research is needed to design the optimal training program.
LEVEL OF EVIDENCE
Therapeutic Level II. See Instructions to Authors for a complete description of levels of evidence.
Topics: Adolescent; Anterior Cruciate Ligament Injuries; Athletes; Athletic Injuries; Child; Education; Female; Humans; Incidence; Knee Injuries; Risk; Rupture; Soccer; Sports; Young Adult
PubMed: 27490154
DOI: 10.2106/JBJS.RVW.M.00129 -
The American Journal of Sports Medicine Mar 2023An acute Achilles tendon rupture is one of the most common sports injuries, affecting 18 per 100,000 persons, and its operative repair has been evolving and increasing... (Meta-Analysis)
Meta-Analysis
Outcomes and Complications of Open Versus Minimally Invasive Repair of Acute Achilles Tendon Ruptures: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
BACKGROUND
An acute Achilles tendon rupture is one of the most common sports injuries, affecting 18 per 100,000 persons, and its operative repair has been evolving and increasing in frequency since the mid-1900s. Traditionally, open surgical repair has provided improved functional outcomes, reduced rerupture rates, and a quicker recovery and return to activities at the expense of increased wound complications such as infections and skin necrosis compared with nonoperative management. In 1977, Ma and Griffith introduced the percutaneous approach, and over the following decades, multiple improved techniques, and modifications thereof, have been described with comparable outcomes with open repair.
PURPOSE
The current study aimed to provide updated level 1 evidence comparing open repair with minimally invasive surgery (MIS) through a comprehensive search of the literature published in English, Arabic, Spanish, Portuguese, and German while avoiding limitations of previous studies such as heterogeneous study designs and a small number of included trials.
STUDY DESIGN
Meta-analysis; Level of evidence, 1.
METHODS
Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, 2 independent team members searched several databases to identify randomized controlled trials (RCTs) comparing open repair and MIS of Achilles tendon ruptures. The primary outcomes were (1) functional outcomes, (2) reruptures, (3) sural nerve injuries, and (4) infections (deep/superficial), whereas the secondary outcomes were (1) skin complications, (2) adhesions, (3) other complications, (4) ankle range of motion, and (5) surgical time.
RESULTS
There were 10 RCTs that qualified for the meta-analysis with a total of 522 patients. Overall, 260 (49.8%) patients underwent open repair, while 262 (50.2%) underwent MIS. The mean postoperative AOFAS score was 94.8 and 95.7 for open repair and MIS, respectively, with a nonsignificant difference (mean difference [MD], -0.73 [95% CI, -1.70 to 0.25]; .14; = 0%). The pooled mean total complication rate was 15.5% (0%-36.4%) for open repair and 10.4% (0%-45.5%) for MIS, with a nonsignificant statistical difference (odds ratio [OR], 1.50 [95% CI, 0.87-2.57]; = .14; = 40%). The mean rerupture rate was 2.5% (0%-6.8%) for open repair versus 1.5% (0%-4.6%) for MIS, with a nonsignificant statistical difference (OR, 1.56 [95% CI, 0.42-5.70]; = .50; = 0%). No cases of sural nerve injuries were reported in the open repair group. The mean sural nerve injury rate was 3.4% (0%-7.3%) in the MIS group, which was statistically significant (OR, 0.16 [95% CI, 0.03-0.46]; = .02; = 0%). The mean overall superficial infection rate was 6.0% (0%-18.2%) and 0.4% (0%-4.5%) for open repair and MIS, respectively, with a statistically significant difference (OR, 5.70 [95% CI, 1.80-18.02]; < .001; = 0%). The mean overall deep infection rate reported in the open repair group was 1.4% (0%-5.0%), while no deep infection was reported in the MIS group, with no statistically significant difference (OR, 3.14 [95% CI, 0.48-20.54]; = .23; = 0%). There were no significant differences between the open repair and MIS groups in the skin necrosis and dehiscence rate, adhesion rate, or keloid scar rate. The mean surgical time was 51.0 and 29.7 minutes for open repair and MIS, respectively, with a statistically significant difference (MD, 21.13 [95% CI, 15.50-26.75]; < .001; = 15%).
CONCLUSION
Open Achilles tendon repair was associated with a longer surgical time, higher risk of superficial infections, and higher risk of ankle stiffness, while MIS was associated with a greater risk of temporary sural nerve palsy. The rerupture rate and functional outcomes were mostly equivalent. We found MIS to be a safe and reliable technique. However, high-quality standardized RCTs are still needed before recommending MIS as the gold standard for managing Achilles tendon ruptures.
Topics: Humans; Achilles Tendon; Rupture; Randomized Controlled Trials as Topic; Tendon Injuries; Acute Disease; Ankle Injuries; Minimally Invasive Surgical Procedures; Necrosis; Treatment Outcome
PubMed: 34908499
DOI: 10.1177/03635465211053619 -
Journal of Vascular Surgery Mar 2014Limited data exist regarding the development of abdominal compartment syndrome (ACS) after endovascular repair of ruptured abdominal aortic aneurysms (RAAAs). We aimed... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Limited data exist regarding the development of abdominal compartment syndrome (ACS) after endovascular repair of ruptured abdominal aortic aneurysms (RAAAs). We aimed to record the incidence, management, and outcome of this complication.
METHODS
A systematic review and meta-analysis of the English language literature was undertaken through June 2012. Articles reporting data on outcome after endovascular repair of RAAAs were identified, and information regarding ACS was sought.
RESULTS
Included were 39 eligible studies reporting 1134 patients. The pooled perioperative mortality was 21% (95% confidence interval [CI], 18%-24%). A total of 109 cases of ACS were recorded. There was significant within-study heterogeneity (Cochran Q = 94.1; P < .0001), and the pooled ACS rate was 8% (95% CI, 5.6%-10.8%). Only six studies accurately defined ACS, and four focused specifically on ACS. When the meta-analysis was repeated after including only studies with a definition and those focusing on ACS, the pooled rate increased to 17% (95% CI, 10%-26%) and 21% (95% CI, 13%-30%), respectively. A random-effects meta-regression analysis investigating the effect of ACS and other risk factors on mortality revealed a significant linear correlation between hemodynamic instability and death (r = 0.303) and a nonlinear (second degree polynomial) association between bifurcated endograft approach and death (R(2) = 0.348; P = .0027). However, no statistically significant association could be found between ACS and death. A further meta-regression analysis failed to identify any statistically significant predictors of ACS. Treatment included open decompression in 86 patients, percutaneous drainage in 18 (catheter only in five, combined with tissue plasminogen activator infusion in 13), and conservative measures in five. Data on outcome of ACS were only available for 76 patients; 35 of these died, for a mortality rate of 47%.
CONCLUSIONS
The pooled ACS rate was calculated at 8%, but this figure may be >20% with improved awareness and vigilant monitoring. Although no statistically significant association could be found between ACS and death, almost half the patients who developed ACS after endovascular repair of RAAAs were likely to die.
Topics: Aortic Aneurysm, Abdominal; Aortic Rupture; Blood Vessel Prosthesis Implantation; Decompression, Surgical; Drainage; Endovascular Procedures; Hemodynamics; Humans; Incidence; Intra-Abdominal Hypertension; Nonlinear Dynamics; Reoperation; Risk Factors; Treatment Outcome
PubMed: 24439324
DOI: 10.1016/j.jvs.2013.11.085