title: Contemporary results for open repair of suprarenal and type IV thoracoabdominal aortic aneurysms.
abstract: BACKGROUND
  Endovascular and hybrid procedures are not yet widely established in the management of type IV thoracoabdominal aortic aneurysm (TAAA). Open surgery remains the treatment of choice until the long-term outcomes of these novel techniques are known.
  
  
  METHODS
  This study reviewed a 10-year experience of open repair of non-ruptured type IV and suprarenal TAAA. All procedures were performed using a totally abdominal approach with supracoeliac clamping of the aorta.
  
  
  RESULTS
  There were 53 patients (31 men; 58 per cent) of median age 69 (range 54-82) years. Forty-four patients had a type IV TAAA and nine a suprarenal aneurysm. Three patients (6 per cent) died within 30 days and the 12-month mortality rate for patients followed for at least 1 year was 6 per cent (three of 49). Ten patients (19 per cent) had a cardiac complication, 20 (38 percent) a respiratory complication, three (6 percent) required early reoperation, and one patient (2 percent) developed permanent paraplegia. There was one late death resulting from an aneurysm-related complication.
  
  
  CONCLUSIONS
  Open repair of suprarenal aneurysms and type IV TAAA may be undertaken using a totally abdominal approach with acceptable levels of morbidity and mortality.
authors: Vascular Surgical Service, Royal Infirmary of Edinburgh, Edinburgh, UK. jenny.richards@ed.ac.uk
authors: J M J
authors: JM
authors: Richards
authors: A F
authors: AF
authors: Nimmo
authors: C R
authors: CR
authors: Moores
authors: P A
authors: PA
authors: Hansen
authors: J A
authors: JA
authors: Murie
authors: R T A
authors: RT
authors: Chalmers
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017545:Aortic Aneurysm, Thoracic / Q000401:mortality / Q000601:surgery*; D003250:Constriction; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D016896:Treatment Outcome