Activated coagulation during open and endovascular abdominal aortic aneurysm repair

Englberger, Lars; Savolainen, Hannu; Jandus, Peter; Widmer, Matthias; Do, Do Dai; Haeberli, Andre; Baumgartner, Iris; Carrel, Thierry P; Schmidli, Juerg (2006). Activated coagulation during open and endovascular abdominal aortic aneurysm repair. Journal of vascular surgery, 43(6), pp. 1124-9. Amsterdam: Elsevier 10.1016/j.jvs.2006.02.029

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OBJECTIVE: The study was conducted to determine activation of coagulation in patients undergoing open and endovascular infrarenal abdominal aortic aneurysm repair (EVAR). METHODS: In a prospective, comparative study, 30 consecutive patients undergoing open repair (n = 15) or EVAR (n = 15) were investigated. Blood samples to determine fibrinopeptide A, fibrin monomer, thrombin-antithrombin complex, and D-dimer were taken up to 5 days postoperatively. Routine hematologic and hematochemical parameters as well as clinical data were collected. RESULTS: Both groups showed comparable demographic variables. Operating time was longer in open repair (249 +/- 77 minutes vs 186 +/- 69 minutes, P < .05). Perioperatively elevated markers of coagulation were measured in both groups. Fibrinopeptide A levels did not differ significantly between the groups (P = .55). The levels of fibrin monomer and thrombin-antithrombin complex were significantly higher in patients undergoing EVAR (P < .0001), reflecting increased thrombin activity and thrombin formation compared with open surgery. The D-dimer level did not differ significantly between the groups. These results were also valid after correction for hemodilution. CONCLUSION: These data suggest increased procoagulant activity in EVAR compared with open surgery. A procoagulant state may favor possible morbidity derived from micro- and macrovascular thrombosis, such as in myocardial infarction, multiple organ dysfunction, venous thrombosis and thromboembolism, or disseminated intravascular coagulation.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiovascular Surgery
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > Unit Childrens Hospital > Thromboselabor Kinderklinik (discontinued)
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Angiology

UniBE Contributor:

Englberger, Lars; Savolainen, Hannu Olavi; Widmer, Matthias Kurt; Haeberli, André; Baumgartner, Iris; Carrel, Thierry and Schmidli, Jürg

ISSN:

0741-5214

ISBN:

16765226

Publisher:

Elsevier

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:45

Last Modified:

04 May 2014 23:13

Publisher DOI:

10.1016/j.jvs.2006.02.029

PubMed ID:

16765226

Web of Science ID:

000238046700011

URI:

https://boris.unibe.ch/id/eprint/18778 (FactScience: 1016)

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