CV
Table 3: Experience with open abdominal management following open repair of rAAA (adapted and updated from Ross et al. [17]).
Reference
# of patients / #
reopened for ACS
Kron et al. [7]
4/4
Fietsam et al. [8]
6/4
Technique
Marlex mesh bridge
Akers et al. [9]
6 (1/6 TAAA)
Silicone rubber sheet
Oelschlager et al. [10]
8
Plastic sheet (6), Skin
closure (2)
Gore-tex bridge
Ciresi et al. [11]
9
Rasmussen et al. [12]
45/10
Foy et al. [13]
21/4
Barker et al. [14]
22/3
Kushimoto et al. [15]
5
Petersson et al. [16]
Ross et al.. [17]
7
23
Seternes et al. [18]
9/7
Morisaki et al. [19]
3
Acosta et al. [20]
30*
Time to closure
(days)
12 (median)
7.9 +/- 3.2
Survival (%)
100
None
50
None
50
None
50
None
78
None
Mesh (Plastic 69%,
2-7 (range)
PTFE 13%, other 18%)
Sewn to fascia (84%),
sewn to skin (16%)
Plastic sheet
44
Primary fascial closure 4 +/- 3.3
(14), skin graft/mesh
(2)
Soft tissue flap
4 (median)
59.1
Mesh bridge
All vacuum packed,
mesh bridge (9), towel
to fascia (4), no fascial
fixation (10)
Vacuum packed with
mesh sewn to fascia
Vacuum packed with
plastic bag to fascia
Vacuum packed with
mesh traction closure
Graft infection
Mean follow up
Actuarial 32% survival
(95% CI 19-54%) to
5 years
None
None
80
None
32 (median)
100
5.3 +/- 6 (2 to 29) 4 in 78
rAAA patients (2 to 7)
None
None
9 months (median)
53 +/- 24 months (13
to 107 months)
10.5 (median ), 6-19
(range)
6.3
66
None
17 months
100
None
Undefined*
70
1 aortic stent graft
* 30 patients in the Acosta et al. [20] series were treated for rAAA. Details specific to these patients were, otherwise, unreported with the exception of one aortic stent graft infection.
Bozeman, Ross
local anesthesia with sedation as well. In our center, we favor permissive hypotension as low as a systolic pressure of
80 mmHg with sustained level of consciousness combined
with local anesthesia and sedation for REVAR.
Whether the broad adoption and implementation of these
management strategies prior to definitive aortic repair
will decrease the incidence of postoperative IAH and ACS
remains to be seen.
Mayer et al. [32] retrospectively reviewed an extensive,
single center’s experience spanning the decade from
1998–2008 with REVAR. Starting in 2000, this group used
REVAR, by protocol, for all rAAA patients with favorable
anatomy and accessible ili