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aneurysm blood transfusion

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https://www.readbyqxmd.com/read/29131276/the-expression-of-mmp-7-in-serum-and-aneurysm-tissues-of-patients-with-abdominal-aortic-aneurysm-associated-with-hypertension-and-the-clinical-efficacy-of-endovascular-exclusion
#1
W-H Zhang, C-H Qiao, X Zhang, H Luo, X-K Sun
OBJECTIVE: To investigate the expression of matrix metalloproteinase-7 (MMP-7) in abdominal aortic aneurysm (AAA) with hypertension, and the clinical efficacy of endovascular exclusion. PATIENTS AND METHODS: Seventy-two cases of AAA with hypertension were retrospectively analyzed. Patients were divided into the observation group (34 cases) and control group (38 cases). The control group was treated by AAA incision with artificial vascular replacement, while the observation group was treated by endovascular graft exclusion...
October 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29122422/comparison-of-open-surgical-techniques-for-repair-of-types-iii-and-iv-thoracoabdominal-aortic-aneurysms
#2
Muhammad A Rana, Peter Gloviczki, Audra A Duncan, Manju Kalra, Kevin L Greason, Gustavo S Oderich, Stephen S Cha, Thomas C Bower
OBJECTIVE: The objective of this study was to compare outcomes after repair of type III and type IV thoracoabdominal aortic aneurysms (TAAAs) by three different open surgical techniques at a tertiary care institution. METHODS: Consecutive patients who underwent elective repair of type III and type IV TAAAs at our institution between 1999 and 2011 were retrospectively reviewed. Patients were divided into three groups according to surgical technique: clamp and sew (CS), left-sided heart bypass (LHB), and visceral branching (VB) followed by aortic reconstruction...
November 6, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29112541/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-cardiovascular-and-thoracic-surgery
#3
Aamer B Ahmed, Andreas Koster, Marcus Lance, David Faraoni
: None of the predictive models for venous thromboembolism (VTE) prophylaxis have been designed for and validated in patients undergoing cardiothoracic and vascular surgery. The presence of one or more risk factors [age over 70 years old, transfusion of more than 4 U of red blood cells/fresh frozen plasma/cryoprecipitate, mechanical ventilation lasting more than 24 h, postoperative complication (e.g. acute kidney injury, infection/sepsis, neurological complication)] should place the cardiac population at high risk for VTE...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29038077/the-effects-of-red-blood-cell-transfusion-on-functional-outcome-after-aneurysmal-subarachnoid-hemorrhage
#4
Monisha A Kumar, Joshua Levine, Jennifer Faerber, J Paul Elliott, H Richard Winn, Sean Doerfler, Peter Le Roux
BACKGROUND: The optimal red blood cell transfusion (RBCT) trigger for patients with aneurysmal subarachnoid hemorrhage (SAH) is unknown. In patients with cerebral vasospasm, anemia may increase susceptibility to ischemic injury; conversely, RBCT may worsen outcome given known deleterious effects. OBJECTIVE: To examine the association between RBCT, delayed cerebral ischemia, vasospasm, and outcome after SAH. METHODS: 421 consecutive SAH patients, admitted to a Neurocritical Care Unit at a University affiliated hospital and who underwent surgical occlusion of their ruptured aneurysm were retrospectively identified from a prospective observational database...
October 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29034016/improved-outcomes-for-ruptured-abdominal-aortic-aneurysms-using-integrated-management-involving-endovascular-clamping-endovascular-replacement-and-open-abdominal-decompression
#5
Chikashi Aoki, Norihiro Kondo, Yoshiaki Saito, Satoshi Taniguchi, Wakako Fukuda, Kazuyuki Daitoku, Ikuo Fukuda
Objective: Endovascular repair has become the treatment of choice for ruptured abdominal aortic aneurysms (RAAAs). To improve surgical outcomes, preoperative management is important. In 2011, we introduced integrated management, which involves endovascular aneurysm repair, stabilization of hemodynamics by endovascular clamping, and open abdominal decompression to address abdominal compartment syndrome (ACS). Methods: To evaluate the efficacy of this management strategy, 62 patients who had undergone emergency surgery for an RAAA were analyzed retrospectively: group A (n=39), where an old strategy was used, and group B (n=23), where integrated management was introduced...
March 24, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29017806/implementation-of-a-bundled-protocol-significantly-reduces-risk-of-spinal-cord-ischemia-after-branched-or-fenestrated-endovascular-aortic-repair
#6
Salvatore T Scali, Moses Kim, Paul Kubilis, Robert J Feezor, Kristina A Giles, Brittney Miller, Javairiah Fatima, Thomas S Huber, Scott A Berceli, Martin Back, Adam W Beck
OBJECTIVE: Spinal cord ischemia (SCI) is a devastating complication after branched or fenestrated endovascular aortic repair (B/FEVAR) for thoracoabdominal aortic disease. The purpose of this analysis was to describe the impact of a bundled clinical care protocol designed to reduce the risk of SCI in this population of patients. METHODS: A bundled SCI prevention protocol including cerebrospinal fluid drainage, blood pressure parameters, transfusion goals, and pharmacologic adjuncts (steroids, naloxone) was initiated in May 2015...
October 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28965799/multifactorial-risk-index-for-prediction-of-intraoperative-blood-transfusion-in-endovascular-aneurysm-repair
#7
Eitezaz Mahmood, Robina Matyal, Ariel Mueller, Feroze Mahmood, Avery Tung, Mario Montealegre-Gallegos, Marc Schermerhorn, Sajid Shahul
BACKGROUND: In some institutions, the current blood ordering practice does not discriminate minimally invasive endovascular aneurysm repair (EVAR) from open procedures, with consequent increasing costs and likelihood of blood product wastage for EVARs. This limitation in practice can possibly be addressed with the development of a reliable prediction model for transfusion risk in EVAR patients. We used the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database to create a model for prediction of intraoperative blood transfusion occurrence in patients undergoing EVAR...
September 28, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28950789/treatment-of-aneurysmal-bone-cysts-with-bioactive-glass-in-children
#8
J Syvänen, Y Nietosvaara, I Kohonen, E Koskimies, M Haara, J Korhonen, O Pajulo, I Helenius
BACKGROUND AND AIMS: Aneurysmal bone cysts represent about 1% of primary bone tumors. The standard treatment is curettage, followed by local adjuvant treatments and bone grafting. The problem is the high recurrence rate. The purpose of this study was to evaluate retrospectively the use of bioactive glass as a filling material in the treatment of aneurysmatic bone cysts in children. MATERIAL AND METHODS: A total of 18 consecutive children (mean 11.3 years at surgery; 10 males; 11 lower, 6 upper limb, 1 pelvis; 15 with primary surgery) with histologically proven primary aneurysmal bone cysts operated with curettage and bioactive glass filling between 2008 and 2013 were evaluated after a mean follow-up of 2...
September 1, 2017: Scandinavian Journal of Surgery: SJS
https://www.readbyqxmd.com/read/28947229/effect-of-postoperative-anemia-and-baseline-cardiac-risk-on-serious-adverse-outcomes-after-major-vascular-interventions
#9
Panos Kougias, Sherene Sharath, Neal R Barshes, Millie Chen, Joseph L Mills
OBJECTIVE: Published data suggest that permissive anemia strategies that allow nadir hemoglobin (nHb) values of 7 g/dL or lower are safe in a variety of clinical settings. The appropriateness of these strategies in patients at high risk for adverse postoperative cardiac events remains unclear. We sought to determine the combined effect of postoperative nHb and cardiac risk status on major complications after vascular surgical interventions. METHODS: This was a single-institution retrospective analysis of consecutive patients who underwent elective open procedures for occlusive vascular disease and aneurysm repair, either open or endovascular...
September 22, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28913787/mortality-rates-and-risk-factors-for-emergent-open-repair-of-abdominal-aortic-aneurysms-in-the-endovascular-era
#10
Felice Pecoraro, Steffen Gloekler, Caecilia E Mader, Malgorzata Roos, Lyubov Chaykovska, Frank J Veith, Neal S Cayne, Nicola Mangialardi, Thomas Neff, Mario Lachat
The background of this paper is to report the mortality at 30 and 90 days and at mean follow-up after open abdominal aortic aneurysms (AAA) emergent repair and to identify predictive risk factors for 30- and 90-day mortality. Between 1997 and 2002, 104 patients underwent emergent AAA open surgery. Symptomatic and ruptured AAAs were observed, respectively, in 21 and 79% of cases. Mean patient age was 70 (SD 9.2) years. Mean aneurysm maximal diameter was 7.4 (SD 1.6) cm. Primary endpoints were 30- and 90-day mortality...
September 14, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28893702/risk-factors-associated-with-perioperative-myocardial-infarction-in-major-open-vascular-surgery
#11
Danielle C Sutzko, Elizabeth A Andraska, Andrea T Obi, Peter K Henke, Nicholas H Osborne
BACKGROUND: Among patients undergoing noncardiac surgery, major vascular surgery is associated with a high risk of perioperative myocardial infarction (MI). Currently, there are no perioperative MI risk calculators accounting for intraoperative and postoperative risk factors in vascular surgery patients. We aimed to investigate specific risk factors for perioperative MI after major open vascular surgery to determine which patients are at highest risk of MI and the association of perioperative MI with perioperative transfusion...
September 8, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28887236/iatrogenic-major-venous-injury-is-associated-with-increased-morbidity-of-aortic-reconstruction
#12
Sachinder S Hans, Steven Vang, Gul Sachwani-Daswani
BACKGROUND: Major venous injury during open aortic reconstruction though uncommon often result in sudden and massive blood loss resulting in increased morbidity and mortality. This study details the etiology, management, and outcome of such injuries. METHODS: A retrospective review of 945 patients (1981-2017) undergoing aortic reconstruction from 2 midsized (350 bed each) teaching hospitals was conducted. Seven hundred twenty-three patients (76.5%) underwent open abdominal aortic aneurysm (AAA) repair/iliac aneurysm repair, 222 patients (23...
September 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28870681/the-association-of-venous-thromboembolism-chemoprophylaxis-timing-on-venous-thromboembolism-after-major-vascular-surgery
#13
Danielle C Sutzko, Patrick E Georgoff, Andrea T Obi, Mark A Healy, Nicholas H Osborne
OBJECTIVE: Venous thromboembolism (VTE) is reported to occur in up to 33% of patients undergoing major vascular surgery. Despite this high incidence, patients inconsistently receive timely VTE chemoprophylaxis. The true incidence of VTE among patients receiving delayed VTE chemoprophylaxis is unknown. We sought to identify the association of VTE chemoprophylaxis timing on VTE risk, postoperative transfusion rates, and 30-day mortality and morbidity in patients undergoing major open vascular surgery...
September 1, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28841130/outcomes-of-open-and-endovascular-repair-of-inflammatory-abdominal-aortic-aneurysms
#14
África Duque Santos, Andrés Reyes Valdivia, María Asunción Romero Lozano, Enrique Aracil Sanus, Julia Ocaña Guaita, Claudio Gandarias
Objective Reports on inflammatory aortic abdominal aneurysm treatment are scarce. Traditionally, open surgery has been validated as the gold standard of treatment; however, high technical skills are required. Endovascular aortic repair has been suggested as a less invasive treatment by some authors offering good results. The purpose of our study was to report our experience and outcomes in the treatment of inflammatory aortic abdominal aneurysm using both approaches. Material and methods A retrospective review and data collection of all patients treated for inflammatory aortic abdominal aneurysm between 2000 and 2015 was done in one academic center...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28801322/portal-vein-aneurysm-in-thalassaemia
#15
Simi Das, Mousam Dey, Vinay Kumar, Hira Lal
Arterial aneurysms are more common than visceral venous aneurysms. Portal vein aneurysms being the most common type of visceral venous aneurysms. Here, we present an 18-year-old young woman with thalassaemia major, who presented with headache, palpitation, shortness of breath and a recent increase in blood transfusion rate. On clinical examination, she had hepatosplenomegaly. Ultrasonography revealed hepatosplenomegaly with fusiform dilatation of extrahepatic portal vein, which was confirmed to be portal vein aneurysm on contrast enhanced CT...
August 11, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28689939/variation-in-transfusion-practices-and-the-association-with-perioperative-adverse-events-in-patients-undergoing-open-abdominal-aortic-aneurysm-repair-and-lower-extremity-arterial-bypass-in-the-vascular-quality-initiative
#16
Zachary Osborne, Kristine Hanson, Benjamin S Brooke, Marc Schermerhorn, Peter Henke, Rumi Faizer, Andres Schanzer, Philip Goodney, Thomas Bower, Randall R DeMartino
BACKGROUND: Blood transfusions are associated with adverse events. We examined perioperative transfusion practices and associated complications following open vascular procedures nationwide in the Vascular Quality Initiative (VQI). METHODS: Adults undergoing open abdominal aortic aneurysm repair (OAR) and lower extremity arterial bypass (Bypass) within VQI (2003-2016) were identified. All emergent cases, patients with preoperative hemoglobin <7 g/dL, preoperative hospitalization >1 day, or a return to operating room during the index hospitalization were excluded...
July 8, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28681751/assessment-of-surgical-risk-factors-in-the-development-of-ventilator-associated-pneumonia-in-neurosurgical-intensive-care-unit-patients-alarming-observations
#17
Deepashu Sachdeva, Daljit Singh, Poonam Loomba, Amandeep Kaur, Monica Tandon, Ishu Bishnoi
BACKGROUND: Ventilator-associated pneumonia (VAP) is the most frequent nosocomial infection in patients receiving mechanical ventilation (MV) and contributes to a longer intensive care unit (ICU) stay, duration of MV, and a high morbidity and mortality. OBJECTIVE: The purpose of study was to determine the incidence of VAP in neurosurgery ICU patients and to assess the probable contributing neurosurgical risk factors like the site and nature of the lesion in the brain, the duration of surgery, blood loss during surgery, and infection elsewhere in the body, in the development of VAP...
July 2017: Neurology India
https://www.readbyqxmd.com/read/28595228/-delayed-hemolytic-anemia-associated-with-anti-jk3-antibody-following-cardiovascular-surgery-report-of-a-case
#18
Takayuki Nishimoto, Yukihiro Bonkohara, Masaki Iijima
We report a 73-year-old man who underwent total aortic arch replacement with an open stent graft for aortic arch aneurysm. The patient received blood transfusion intraoperatively without any signs of hemolysis. However, on post-operative day 16, he developed hemoglobinuria, and was found to have anemia, elevated serum lactate dehydrogenase, elevated total bilirubin, and decreased serum haptoglobin. Initially, the cause for these findings was unknown. Upon further testing, however, antibodies against the high frequency antigen, anti-Jk3 was identified...
June 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28514895/outcomes-after-use-of-aortouniiliac-endoprosthesis-versus-modular-or-unibody-bifurcated-endoprostheses-for-endovascular-repair-of-ruptured-abdominal-aortic-aneurysms
#19
COMPARATIVE STUDY
Prateek K Gupta, Kelly Kempe, Reshma Brahmbhatt, Himani Gupta, Jorge Montes, R Armour Forse, Shaun M Stickley, Michael J Rohrer
OBJECTIVES: Outcomes after endovascular repair (EVAR) of ruptured abdominal aortic aneurysms (rAAAs) have been widely published. There is, however, controversy on the role of the use of aortouniiliac endoprosthesis (AUI) versus modular or unibody bifurcated endoprosthesis (MUB) for repair of rAAAs. We study and compare 30-day outcomes after use of AUI and MUB for all rAAAs focusing specifically on patients with instability. MATERIALS AND METHODS: Patients who underwent EVAR for rAAA (n = 425) using AUI (n = 55; 12...
August 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28487456/deriving-literature-based-benchmarks-for-surgical-complications-in-high-income-countries-a-protocol-for-a-systematic-review-and-meta-analysis
#20
Mary E Brindle, Derek J Roberts, Oluwatomilayo Daodu, Alex Bernard Haynes, Christy Cauley, Elijah Dixon, Claude La Flamme, Paul Bain, William Berry
INTRODUCTION: To improve surgical safety, health systems must identify preventable adverse outcomes and measure changes in these outcomes in response to quality improvement initiatives. This requires understanding of the scope and limitations of available population-level data. To derive literature-based summary estimates of benchmarks of care, we will systematically review and meta-analyse rates of postoperative complications associated with several common and/or high-risk operations performed in five high-income countries (HICs)...
May 9, 2017: BMJ Open
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