Incidence and Risk Factors of Perioperative Complications in Patients Undergoing Elective Endovascular Aneurysm Repair for Asymptomatic Infrarenal Abdominal Aortic Aneurysms
Keywords:
perioperative complication, endovascular aneurysm repair, abdominal aortic aneurysm, anesthesiaAbstract
Endovascular aneurysm repair (EVAR) is currently the main therapeutic intervention for abdominal aortic aneurysm. The present study aimed to evaluate the incidence and perioperative factors associated with perioperative complications in patients who underwent EVAR for elective asymptomatic abdominal aortic aneurysm. This retrospective descriptive study was conducted in patients with asymptomatic infrarenal aortic aneurysm who underwent elective EVAR at Siriraj Hospital between 2010 and 2020. Demographic data, procedural data, anesthetic data, and perioperative adverse events were extracted. The primary outcome was the incidence of in-hospital perioperative complications. Multivariable logistic regression was used to determine perioperative factors associated with perioperative adverse events. A total of 427 patients with asymptomatic abdominal aortic aneurysm who underwent elective EVAR were included. The mortality rate was 1.2%. The incidence of perioperative complications was 23.9%, with a total of 169 adverse events. The most common complications were wound hematoma (7.0%), acute kidney injury (6.9%), and hospital-acquired pneumonia (4.7%). Multiple logistic regression identified factors associated with perioperative complications, including pre-existing arrhythmia (adjusted OR, aOR 3.84; 95%CI, 1.74-8.49, p<0.05), anesthesia duration of more than 4 hours (aOR 2.25; 95%CI, 1.31-3.88, p<0.05), general anesthesia (aOR 2.06; 95%CI, 1.19-3.54, p<0.05), and maximum aneurysm diameter of more than 60 mm (aOR 1.88; 95%CI, 1.12-3.13, p<0.05).In conclusion, the incidence of perioperative complications in asymptomatic abdominal aortic aneurysm patients who underwent elective EVAR was common. Optimization of preoperative conditions and avoidance of modifiable factors might prevent postoperative complications related to the EVAR procedure.
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