Ruptured Abdominal Aortic Aneurysm: The Definitive Manual

416 Pages·2017·11.84 MB·English

by  Benjamin W. Starnes

Ruptured
Abdominal Aortic
Aneurysm
The Defi nitive Manual
Benjamin W. Starnes
Manish Mehta
Frank J. Veith
Editors
123
Ruptured Abdominal Aortic Aneurysm
Benjamin W. Starnes • Manish Mehta
Frank J. Veith
Editors
Ruptured Abdominal Aortic
Aneurysm
The Definitive Manual
Editors
Benjamin W. Starnes Frank J. Veith
Harborview Medical Center Bronx, NY
University of Washington USA
Seattle, WA
USA
Manish Mehta
Albany Medical Center
Albany, NY
USA
ISBN 978-3-319-23843-2 ISBN 978-3-319-23844-9 (eBook)
DOI 10.1007/978-3-319-23844-9
Library of Congress Control Number: 2016963217
© Springer International Publishing Switzerland 2017
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Foreword
The editors—Benjamin Starnes, Manish Mehta, and Frank Veith—are to be con-
gratulated on their contemporary manual on the management of ruptured abdominal
aortic aneurysms. This brand-new textbook is the first of its kind to address rupture
exclusively, and the result is a truly exceptional educational reference for aortic
surgeons.
Rupture remains a life-threatening complication of aortic disease. Aortic rupture
may occur in a previously unrepaired section from a de novo aneurysm or as a late
complication of prior repair in patients who are known to have aortic disease and are
participating in a surveillance protocol to monitor aortic dimensions. In patients
with undiagnosed aortic disease, aortic rupture is an unexpected complication—
delay related to the inability to establish diagnosis or for other reasons further
increases the risk of death. In consideration of the challenge that repair poses in
patients who present with aortic rupture, the editors of this manual have presented a
thorough review of operative strategies for the treatment of rupture, including the
entire range of open and endovascular approaches and the use of protective tech-
niques such as hypotensive hemostasis. Additionally, the editors have tackled the
equally critical aspects of clinical presentation and diagnostics, which are necessary
for reducing the misdiagnosis of ruptured abdominal aortic aneurysms.
I began my surgical career under the tutelage of the late E.S. Crawford at a time in
which rupture of an aortic aneurysm portended devastating consequences. Today,
despite the advent of itemized improvements in operative techniques and the use of
surgical adjuncts, mortality rates associated with acute rupture of the abdominal aorta
remain high. Collaborative efforts such as this text are critical if we wish to reduce
these rates, and the editors’ and authors’ devotion to this goal is made evident by their
inclusion of several chapters dedicated to tackling postoperative complications after
rupture, postoperative ICU management, and improved quality of life. The manual’s
focus on rupture is additionally beneficial because bringing more attention to this life-
threatening condition may improve patient adherence to surveillance imaging proto-
cols, thereby reducing the risk of rupture in future patient populations.
In conclusion, this manual provides a comprehensive overview of the clinical
presentation and management of rupture, providing aortic surgeons a convenient
v
vi Foreword
resource to consult. Drs. Starnes, Mehta, and Veith are to be applauded for their
efforts in compiling this exhaustive body of work. This guide represents a substan-
tial step forward in our collective understanding of ruptured abdominal aortic
aneurysms.
Joseph S. Coselli, MD
Cullen Foundation Endowed Chair
Chief, Division of Cardiothoracic Surgery
Michael E. DeBakey Department of Surgery
Baylor College of Medicine
Chief, Adult Cardiac Surgery
Texas Heart Institute
Contents
1 Historical Perspective on the Treatment of Ruptured
Abdominal Aortic Aneurysms ................................. 1
Frank J. Veith
2 Background Scope of the Problem ............................. 7
Nam T. Tran
3 The Epidemiology of Ruptured Abdominal
Aortic Aneurysm (rAAA) .................................... 15
Peter A. Soden and Marc L. Schermerhorn
4 Pathogenesis of AAA Rupture ................................ 49
Naoki Fujimura and Ronald L. Dalman
5 Wall Stress ................................................ 67
Derek P. Nathan and Benjamin M. Jackson
6 Clinical Presentation of RAAA ............................... 77
Dieter Mayer
7 The Ruptured Abdominal Aorta: Diagnostics ................... 93
Vincent M. Mellnick, Constantine A. Raptis,
Jay P. Heiken, and Sanjeev Bhalla
8 Predictors of Certain Death ................................. 101
William P. Robinson
9 Prehospital Considerations for REVAR ....................... 115
James Pan and Kim J. Hodgson
10 Guidelines for Transfer to Specialized Centers ................. 131
Matthew Mell
vii
viii Contents
11 Hypotensive Hemostasis in Patients Presenting
with Ruptured Aortic Aneurysm ............................. 141
Felice Pecoraro, Bernard Krüger, Johnny Steuer,
Neal Cayne, Zoran Rancic, Frank J. Veith, and Mario Lachat
12 Ruptured Abdominal Aortic Aneurysms:
Aortic Occlusion Balloons .................................. 151
Zachary M. Arthurs
13 Operative Strategies ....................................... 161
Marlin Wayne Causey, Niten Singh, Philip S.K. Paty, Manish Mehta,
Ruth A. Benson, S. Bahia, R.J. Hinchliffe, I.M. Loftus,
Benjamin W. Starnes, Andrew Holden, Kaj H. Johansen,
Matthew J. Eagleton, Jarrad Rowse, Sira M. Duson,
Edward Y. Woo, and Sean P. Lyden
14 Randomized Trials: What is the Evidence? .................... 259
James Budge, Benjamin Patterson, Matt M. Thompson,
Frank J. Veith, and Caron B. Rockman
15 Postoperative Intensive Care Unit Management
After Ruptured Abdominal Aortic Aneurysm .................. 273
John Kuckelman, Alexander Niven, and Matthew J. Martin
16 Postoperative Complications ................................ 311
Kevin Kniery, Scott R. Steele, Martin Björck, Anders Wanhainen,
Anthony M. Roche, Hernando Olivar, Koichiro Nandate,
Shahram Aarabi, Surbhi Mathur, Joseph Cuschieri,
Khanjan H. Nagarsheth, and Saum A. Rahimi
17 Outcomes of Ruptured Aortic Aneurysm: Early and Late ........ 365
Jessica P. Simons and Andres Schanzer
18 Quality of Life After RAAA ................................. 379
April Rodriguez and Elina Quiroga
19 Ethical Issues Regarding rAAA .............................. 385
Deepika Nehra and Samuel P. Mandell
20 US Coding and Reimbursement ............................. 395
Sean P. Roddy
21 Technique of Supraceliac Balloon Control of the Aorta
During Endovascular Repair of Ruptured Abdominal
Aortic Aneurysms ......................................... 403
Todd L. Berland, Frank J. Veith, Neal S. Cayne, Manish Mehta,
Dieter Mayer, and Mario Lachat
Index ........................................................ 409
List of Contributors
Shahram Aarabi, MD Fellow Division of Vascular Surgery, Department of
Surgery, University of Washington, Seattle, WA, USA
Zachary M. Arthurs, MD, RPVI, FACS Department of Vascular Surgery, San
Antonio Military Medical Center, San Antonio, TX, USA
S. Bahia St. Georges University Hospitals NHS Trust, St. Georges University of
London, London, UK
R. A. Benson Department of Vascular Surgery, University Hospitals Coventry and
Warwickshire NHS Trust, Coventry, UK
Todd L. Berland, MD Division of Vascular Surgery, New York University Langone
Medical Center, New York, NY, USA
Sanjeev Bhalla, MD Mallinckrodt Institute of Radiology, Washington University
School of Medicine, St. Louis, MO, USA
Martin Björck Department of Surgical Sciences, Section of Vascular Surgery,
Uppsala University, Uppsala, Sweden
James Budge St George’s Vascular Institute, St George’s Hospital, London, UK
Marlin Wayne Causey, MD University of California-San Francisco, San
Francisco, CA, USA
Neal Cayne, MD Division of Vascular Surgery, New York University Langone
Medical Center, New York, NY, USA
Joseph Cuschieri Department of Surgery, University of Washington, Seattle, WA,
USA
Ron Dalman, MD Stanford Vascular Surgery, Stanford, CA, USA
Sira M. Duson, MD MedStar Health Vascular Surgery, MedStar Vascular Program,
Department of Vascular Surgery, Georgetown University, Washington, DC, USA,
ix
x List of Contributors
Matthew J. Eagleton, MD Department of Vascular Surgery, H32, Cleveland
Clinic Lerner College of Medicine-CWRU, Cleveland, OH, USA
Jay P. Heiken, MD Mallinckrodt Institute of Radiology, Washington University
School of Medicine, St. Louis, MO, USA
R. J. Hinchliffe Bristol Centre for Surgical Research, University of Bristol, Bristol,
UK
Kim J. Hodgson, MD Division of Vascular Surgery, Southern Illinois University
School of Medicine, Springfield, IL, USA
Andrew Holden, MBChB Department of Interventional Radiology, Auckland
Hospital, Auckland, New Zealand
Benjamin M. Jackson, MD University Of Pennsylvania, Philadelphia, PA, USA
Kaj H. Johansen, MD, PhD, FACS Vascular Surgery, Swedish Medical Center,
University of Washington School of Medicine, Seattle, WA, USA
Kevin Kniery, MD Department of Surgery, Division of Colorectal Surgery,
Madigan Army Medical Center, Tacoma/Fort Lewis, WA, USA
Bernard Krüger Vascular Surgery Unit, University of Palermo, University
Hospital ‘P. Giaccone’, Palermo, Italy
John Kuckelman, DO Department of Surgery, Madigan Army Medical Center,
Tacoma, WA, USA
Mario Lachat, MD Division of Cardiovascular Surgery, University Hospital of
Zurich, Zurich, Switzerland
I. M. Loftus St Georges University Hospitals NHS Trust, St Georges University of
London, London, UK
Sean P. Lyden, MD Department of Vascular Surgery, The Cleveland Clinic
Foundation, Cleveland, OH, USA
Samuel P. Mandell, MD, MPH Department of Surgery, University of Washington,
Harborview Medical Center, Seattle, WA, USA
Matthew J. Martin, MD, FACS Department of Surgery, Madigan Army Medical
Center, Tacoma, WA, USA
Surbhi Mathur, MD Department of Surgery, University of Washington, Seattle,
WA, USA
Dieter Mayer, MD The Division of Vascular Surgery, University Hospital of
Zurich, Zurich, Switzerland
Manish Mehta, MD, MPH Division of Vascular Surgery, Albany Medical
College, Albany, NY, USA
Vascular Health Partners, CCP, Gloversville, NY, USA
Matthew Mell, MD, MS Division of Vascular Surgery, Stanford University School
of Medicine, Stanford, CA, USA