Outcomes of hemodialysis-dependent patients following elective abdominal aortic aneurysm repair.
As hemodialysis-dependent patients have a shorter life expectancy it has been recently questioned whether they benefit from procedures such as abdominal aortic aneurysm (AAA) repair. The purpose of this study was to review our results with elective AAA repair in hemodialysis-dependent patients. During a recent 6-year period (1998-2003), 7 such patients underwent elective repair of their infrarenal aortic aneurysms. Mean age and aneurysm diameter were 71 years and 69 mm, respectively. Mean length of stay was 28.6 days including routine intensive care unit admission. Three patients underwent standard open repair, and 3 underwent endovascular repair. In the seventh patient iliac calcification precluded endograft delivery and resulted in conversion to open repair. Another endovascular patient suffered from perforation of her sigmoid colon. One- and 3-year survival rates in the entire cohort were 100% and 75%, respectively. The authors conclude that aneurysm repair in hemodialysis patients is warranted and life prolonging in appropriate risk patients, despite lengthy hospital stays. However, successful endovascular repair may be prevented by the severe arterial calcification in these patients.
Forbes
Thomas L
TL
The University of Western Ontario, London, ON, Canada. Tom.Forbes@lhsc.on.ca
Lawlor
D Kirk
DK
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000401:mortality / Q000601:surgery*; D002170:Canada / Q000453:epidemiology; D017558:Elective Surgical Procedures / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008297:Male; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000401:mortality / Q000628:therapy; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects