Key result
Proximal aortic clamping during open AAA repair had higher univariate 30-day mortality than infrarenal clamping (3.7% vs 2.0%, p<0.001), but this difference was nonsignificant after adjustment.
Why the study?
The effects of different suprarenal clamping positions on postoperative outcomes after open infrarenal abdominal aortic aneurysm repair needed better characterization.
Does proximal aortic clamping increase postoperative morbidity and mortality compared to infrarenal clamping in patients undergoing open infrarenal AAA repair?
Cohort (n=5,043)
Yes
Does proximal aortic clamping increase postoperative morbidity and mortality compared to infrarenal clamping in patients undergoing open infrarenal AAA repair?
Absolute Event Rate: 3.7% vs 2%
p-value: p=<0.001
During open infrarenal AAA repair, proximal aortic clamping is associated with increased risks of acute kidney injury, dialysis, and cardiac morbidity without affecting perioperative or long-term mortality, suggesting clamping should be performed at the safest, distal-most level.
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Suprarenal clamping in open juxtarenal AAA repair warrants AKI caution; leaves open optimal positioning versus ischemia time.
Natour et al. (2022) conducted a cohort in Open infrarenal abdominal aortic aneurysms (AAA) (n=5,043). Proximal aortic clamping (above 1 renal, above 2 renals, or supraceliac) vs. Infrarenal clamping was evaluated on 30-day mortality (p=<0.001). Proximal aortic clamping during open AAA repair had higher univariate 30-day mortality than infrarenal clamping (3.7% vs 2.0%, p<0.001), but this difference was nonsignificant after adjustment.
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