Comparison of Hybrid Vascular Grafts and Standard Grafts in Terms of Kidney Injury for the Treatment of Thoraco-Abdominal Aortic Aneurysm.
Acute Kidney Injury
/ etiology
Aged
Aged, 80 and over
Aortic Aneurysm, Thoracic
/ surgery
Blood Vessel Prosthesis
/ adverse effects
Blood Vessel Prosthesis Implantation
/ adverse effects
Female
Hospital Mortality
Humans
Kaplan-Meier Estimate
Kidney
/ surgery
Male
Retrospective Studies
Treatment Outcome
Vascular Grafting
/ adverse effects
Vascular Patency
Warm Ischemia
Journal
World journal of surgery
ISSN: 1432-2323
Titre abrégé: World J Surg
Pays: United States
ID NLM: 7704052
Informations de publication
Date de publication:
06 2020
06 2020
Historique:
pubmed:
13
2
2020
medline:
21
1
2021
entrez:
13
2
2020
Statut:
ppublish
Résumé
We present a comparison of renal function outcomes during HTAR with the use of a new hybrid vascular graft (GHVG) or standard graft. It is a multicenter, retrospective, observational study. Between January 2015 and March 2019, 36 patients were treated with HTAR. We compared HTAR performed with the use of the GHVG and with the use of standard bypass graft. Primary outcome measures were hospital mortality, acute kidney injury (AKI) at 30 days and GHVG patency. Mean GHVG ischemia time was significantly lower for both renal arteries (right: GHVG, 4 ± 2 vs. standard graft, 15 ± 7 min; 95% CI 2.23-6.69, P < 0.001; left: GHVG, 3 ± 2 vs. standard graft, 13 ± 7 min; 95% CI 2.44-5.03, P < 0.001). Hospital mortality was 17% (6/36); while mortality did not differ between the two groups, postoperative acute kidney injury rate was 30.5% (11/36 patients) and was more common in the standard graft group (7% vs. 29%; OR 3.2, P = 0.074). Estimated primary patency was 92% ± 2 (95% CI 79.5-97%) at 36 months and was not different between the two groups (GHVG 94% ± 6 vs. standard graft 91% ± 6; log-rank χ In our experience of HTAR, ischemia time was significantly shorter and postoperative AKI occurrence was lower with GHVG if compared to standard graft bypass, with satisfactory midterm patency rate comparable to that of standard graft bypass.
Sections du résumé
BACKGROUND
We present a comparison of renal function outcomes during HTAR with the use of a new hybrid vascular graft (GHVG) or standard graft.
METHODS
It is a multicenter, retrospective, observational study. Between January 2015 and March 2019, 36 patients were treated with HTAR. We compared HTAR performed with the use of the GHVG and with the use of standard bypass graft. Primary outcome measures were hospital mortality, acute kidney injury (AKI) at 30 days and GHVG patency.
RESULTS
Mean GHVG ischemia time was significantly lower for both renal arteries (right: GHVG, 4 ± 2 vs. standard graft, 15 ± 7 min; 95% CI 2.23-6.69, P < 0.001; left: GHVG, 3 ± 2 vs. standard graft, 13 ± 7 min; 95% CI 2.44-5.03, P < 0.001). Hospital mortality was 17% (6/36); while mortality did not differ between the two groups, postoperative acute kidney injury rate was 30.5% (11/36 patients) and was more common in the standard graft group (7% vs. 29%; OR 3.2, P = 0.074). Estimated primary patency was 92% ± 2 (95% CI 79.5-97%) at 36 months and was not different between the two groups (GHVG 94% ± 6 vs. standard graft 91% ± 6; log-rank χ
CONCLUSIONS
In our experience of HTAR, ischemia time was significantly shorter and postoperative AKI occurrence was lower with GHVG if compared to standard graft bypass, with satisfactory midterm patency rate comparable to that of standard graft bypass.
Identifiants
pubmed: 32047985
doi: 10.1007/s00268-020-05415-3
pii: 10.1007/s00268-020-05415-3
doi:
Types de publication
Comparative Study
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
2010-2019Références
J Vasc Surg. 2009 Dec;50(6):1280-4
pubmed: 19958984
J Vasc Surg. 2014 Sep;60(3):622-30
pubmed: 24768367
J Vasc Surg. 2019 May;69(5):1342-1355
pubmed: 30477943
J Am Coll Cardiol. 2003 Apr 16;41(8):1364-72
pubmed: 12706933
J Vasc Surg. 2014 May;59(5):1265-73
pubmed: 24468283
J Vasc Surg. 2009 May;49(5):1125-34
pubmed: 19394542
Vasc Endovascular Surg. 2017 May;51(4):199-202
pubmed: 28424038
J Vasc Surg. 2015 Mar;61(3):793-5
pubmed: 24239520
Ann Vasc Surg. 2015 Oct;29(7):1426-33
pubmed: 26140946
Ann Intern Med. 2013 Jun 4;158(11):825-30
pubmed: 23732715
J Vasc Surg. 2005 Aug;42(2):206-12
pubmed: 16102615
PLoS One. 2015 Oct 15;10(10):e0140817
pubmed: 26469346
Eur J Vasc Endovasc Surg. 2017 Jan;53(1):4-52
pubmed: 28081802
Eur J Cardiothorac Surg. 2012 Apr;41(4):734-44; discussion 744-5
pubmed: 22378855
Ann Thorac Surg. 2013 Jun;95(6):e163-5
pubmed: 23706472
J Thorac Cardiovasc Surg. 2019 Sep;158(3):692-701
pubmed: 30745044
J Vasc Surg. 2018 Jun;67(6):1684-1689
pubmed: 29502996
Eur J Vasc Endovasc Surg. 2009 Nov;38(5):578-85
pubmed: 19666233
Clin Kidney J. 2013 Feb;6(1):8-14
pubmed: 27818745
Vasc Endovascular Surg. 2012 Apr;46(3):258-61
pubmed: 22492109
Ann Cardiothorac Surg. 2014 Jul;3(4):393-9
pubmed: 25133102
J Vasc Surg. 2003 Jun;37(6):1169-74
pubmed: 12764260
J Vasc Surg. 2016 Jul;64(1):33-8
pubmed: 26926940
Sci Rep. 2016 Mar 31;6:23801
pubmed: 27029949
J Thorac Cardiovasc Surg. 2017 Feb;153(2):S32-S41.e7
pubmed: 27866781
Eur J Cardiothorac Surg. 2015 Aug;48(2):180-93
pubmed: 25971435
J Vasc Surg. 2010 Oct;52(4):1022-33, 1033.e15
pubmed: 20888533
J Vasc Surg. 2014 Mar;59(3):817-20
pubmed: 23777810
Ann Thorac Surg. 2010 May;89(5):1475-81
pubmed: 20417763
J Thorac Dis. 2018 May;10(5):2590-2598
pubmed: 29997920
Eur J Cardiothorac Surg. 2009 Jun;35(6):927-30
pubmed: 19339194
Vasc Endovascular Surg. 2018 Apr;52(3):222-225
pubmed: 29366386
Eur J Vasc Endovasc Surg. 2015 May;49(5):534-40
pubmed: 25736516
J Thorac Cardiovasc Surg. 2009 Dec;138(6):1331-8
pubmed: 19660382
Eur J Vasc Endovasc Surg. 2011 Jul;42(1):1-4
pubmed: 21704875
Eur J Cardiothorac Surg. 2016 May;49(5):1374-81
pubmed: 26612715
J Vasc Surg. 2016 May;63(5):1201-7
pubmed: 26776896
Eur J Vasc Endovasc Surg. 2019 Apr;57(4):488-498
pubmed: 30745030
J Vasc Surg. 2012 Sep;56(3):621-9
pubmed: 22575483
J Thorac Cardiovasc Surg. 2016 May;151(5):1323-37
pubmed: 26898979
J Vasc Surg. 2018 Apr;67(4):1017-1024
pubmed: 29056350
J Thorac Cardiovasc Surg. 2018 Dec;156(6):2053-2064.e1
pubmed: 30029784
Eur J Vasc Endovasc Surg. 2016 May;51(5):647-55
pubmed: 26944599
Eur J Vasc Endovasc Surg. 2014 May;47(5):470-8
pubmed: 24656593
J Vasc Surg. 2009 Jul;50(1):15-22
pubmed: 19563950
Ann Vasc Surg. 2019 Feb;55:310.e5-310.e8
pubmed: 30287296
J Vasc Surg. 2012 Dec;56(6):1527-34
pubmed: 23058721
Circulation. 2011 Dec 13;124(24):2670-80
pubmed: 22086877
Am J Cardiol. 2015 Aug 1;116(3):463-8
pubmed: 26026862
Int J Surg. 2014 Dec;12(12):1495-9
pubmed: 25046131
Ann Surg. 2015 Oct;262(4):660-8
pubmed: 26366546
J Vasc Surg. 2018 Dec;68(6):1936-1945.e5
pubmed: 30470373
J Surg Res. 2011 Aug;169(2):311-8
pubmed: 20444476