Optimizing Femoral Access in Emergency EVAR with a Decision-Making Algorithm

被引:0
|
作者
Mirabella, Domenico [1 ]
Bruno, Salvatore [1 ]
La Marca, Manfredi Agostino [1 ]
Dinoto, Ettore [1 ]
Rodriquenz, Edoardo [1 ]
Micciche, Andrea [1 ]
Pecoraro, Felice [1 ,2 ]
机构
[1] AOUP Policlin P Giaccone, Vasc Surg Unit, I-90127 Palermo, Italy
[2] Univ Palermo, Dept Surg Oncol & Oral Sci, I-90133 Palermo, Italy
来源
LIFE-BASEL | 2024年 / 14卷 / 09期
关键词
femoral access; percutaneous access; rAAA; EVAR; surgical conversion; ENDOVASCULAR ANEURYSM REPAIR; PERCUTANEOUS ACCESS; DIFFICULT ACCESS; CLOSURE DEVICES; CUTDOWN ACCESS; PUNCTURE; OUTCOMES; ARTERY;
D O I
10.3390/life14091113
中图分类号
Q [生物科学];
学科分类号
07 ; 0710 ; 09 ;
摘要
Endovascular aneurysm repair (EVAR) has become the preferred approach over open repair for abdominal aortic aneurysms (AAAs) due to its minimally invasive nature. The common femoral artery (CFA) is the main access vessel for EVAR, with both surgical exposure and percutaneous access being utilized. However, in emergent cases, percutaneous access can be challenging and may result in complications such as bleeding or dissection thrombosis, leading to the need for surgical conversion. This study aimed to share experiences in implementing a decision-making algorithm to reduce surgical conversions due to percutaneous access failures. A total of 74 aortic patients treated with EVAR in emergency settings were included in this retrospective study. This study focused on various outcomes such as perioperative mortality, morbidity, procedure time, surgical exposure time, and surgical conversion rate. After the implementation of the decision-making algorithm, decreases in surgical conversions and operating time were observed. Percutaneous access was found to be more challenging in cases with specific anatomical characteristics of the CFA, such as severe atherosclerosis or smaller vessel diameter. This study highlighted the importance of carefully assessing patient anatomical features and utilizing a decision-making algorithm to optimize outcomes in EVAR procedures. Further research is needed to continue improving practices for managing aortic aneurysms and reducing complications in femoral artery access approaches.
引用
收藏
页数:12
相关论文
共 50 条
  • [11] Diagnostic Decision-Making in the Emergency Department
    Medford-Davis, Laura N.
    Singh, Hardeep
    Mahajan, Prashant
    PEDIATRIC CLINICS OF NORTH AMERICA, 2018, 65 (06) : 1097 - +
  • [12] Ethical Decision-making in the Emergency Department
    McGreevy, Jolion
    Isaacs, Eric
    Marill, Keith
    Venkat, Arvind
    ACADEMIC EMERGENCY MEDICINE, 2015, 22 (10) : 1196 - 1196
  • [13] Systems Engineering Decision-making: Optimizing and/or Satisficing?
    Gorod, Alex
    Nguyen, Tiep
    Hallo, Leonie
    2017 11TH ANNUAL IEEE INTERNATIONAL SYSTEMS CONFERENCE (SYSCON), 2017, : 484 - 489
  • [14] ANALYSIS OF DECISION AIDING IN SUBMARINE EMERGENCY DECISION-MAKING
    WEINGAERTNER, ST
    LEVIS, AH
    AUTOMATICA, 1989, 25 (03) : 349 - 358
  • [15] Optimizing Decision-Making in the Gray Zone at Birth
    Verhagen, A. A. E.
    AMERICAN JOURNAL OF BIOETHICS, 2022, 22 (11): : 1 - 3
  • [16] Optimizing pharmacogenomic decision-making by data science
    Behdani, Amir M.
    Lai, Jessica
    Kim, Christina
    Basalelah, Lama
    Halsey, Trey
    Donohoe, Krista L.
    Wijesinghe, Dayanjan
    PLOS DIGITAL HEALTH, 2024, 3 (02):
  • [17] Pediatric head trauma algorithm for head CT decision-making in the emergency department
    Gabriele Savioli
    Iride Francesca Ceresa
    Andrea Piccioni
    Yaroslava Longhitano
    Raymond Planinsic
    Michele Dorfsman
    Antonio Voza
    Federica Manzoni
    Giorgia Caputo
    Abdelouahab Bellou
    Luigi La Via
    Christian Zanza
    Journal of Anesthesia, Analgesia and Critical Care, 5 (1):
  • [18] Optimizing Service Scheduling by Genetic Algorithm Support Decision-Making in Smart Tourism Destinations
    Suanpang, Pannee
    Jamjuntr, Pitchaya
    Decision Making: Applications in Management and Engineering, 2024, 7 (01): : 624 - 650
  • [19] Decision-making algorithm for TS in the ICU
    L Marullo
    A Tavano
    P Fusco
    F Ferraro
    Critical Care, 19 (Suppl 1):
  • [20] A tunable algorithm for collective decision-making
    Pratt, Stephen C.
    Sumpter, David J. T.
    PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA, 2006, 103 (43) : 15906 - 15910