March 3, 2026JVS-Vascular InsightsOpen Access

A Meta-Analysis of the Results of Open Surgical Repair of Infrarenal, Juxtarenal and Type IV Thoracoabdominal Aneurysms

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Why the study?

To evaluate the impact of proximal versus infrarenal aortic cross-clamping on perioperative outcomes during open abdominal aortic aneurysm repair.

Does proximal aortic cross-clamping increase 30-day mortality and perioperative complications compared to infrarenal clamping in patients undergoing open AAA repair?

Comparison

Proximal vs infrarenal aortic cross-clamping

Design

Meta-analysis

Follow-up

30 days

Authors

EÇEren ÇetinelInterventional / Structural Cardiology ADAndressa Frankowski DagostinVita-Salute San Raffaele University RRRafael Andrade RegoNovant Health

Discussion

Member takes

Implication

Supports preferring infrarenal over proximal clamping in open AAA repair when feasible; confirms higher perioperative risk in meta-analysis.

Key Points

Infrarenal clamping shows significantly lower 30-day mortality and renal complications during open abdominal aortic aneurysm repair.
The analysis included 15 studies with 13,140 patients, demonstrating a risk ratio of 2.26 for 30-day mortality favoring infrarenal clamping.
Meta-regression and subgroup analysis highlighted the impact of clamp level on outcomes, especially linking supraceliac clamping to excess mortality.
The findings suggest that using infrarenal clamping could improve early postoperative survival and reduce morbidity.

Structured PICO

Does proximal aortic cross-clamping increase 30-day mortality and perioperative complications compared to infrarenal clamping in patients undergoing open AAA repair?

Population

13,140 patients undergoing open abdominal aortic aneurysm (AAA) repair across 15 studies

Intervention

Proximal aortic cross-clamping (supraceliac and suprarenal)

Comparator

Infrarenal aortic cross-clamping

Outcome

30-day mortalityhard clinical

During open AAA repair, infrarenal aortic clamping is associated with significantly lower 30-day mortality and fewer perioperative complications compared to proximal clamping.

Cite This Study

Çetinel et al. (2026) studied this question.

synapsesocial.com/papers/69a75bd2c6e9836116a23d69 https://doi.org/10.1016/j.jvsvi.2026.100369

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Implication

Supports preferring infrarenal over proximal clamping in open AAA repair when feasible; confirms higher perioperative risk in meta-analysis.

A Meta-Analysis of the Results of Open Surgical Repair of Infrarenal, Juxtarenal and Type IV Thoracoabdominal Aneurysms

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

A Meta-Analysis of the Results of Open Surgical Repair of Infrarenal, Juxtarenal and Type IV Thoracoabdominal Aneurysms

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider