Progress and Future Challenges in Thoracoabdominal Aortic Aneurysm Management

@article{Safi2007ProgressAF,
  title={Progress and Future Challenges in Thoracoabdominal Aortic Aneurysm Management},
  author={Hazim J. Safi and Anthony L Estrera and Ali Azizzadeh and Sheila M. Coogan and Charles C. Miller},
  journal={World Journal of Surgery},
  year={2007},
  volume={32},
  pages={355-360}
}
BackgroundPostoperative paraplegia and paraparesis have been the scourge of thoracoabdominal aortic repair since the inception of the procedure.Methods and ResultsIn our experience with more than 1,250 cases in 15 years, we have developed adjunctive strategies that have pushed neurologic deficit rates down from over 30% percent in the most extensive cases to less than 2% overall in the modern era. The dramatic reductions in risk reported by ourselves and others have led to recent complacency… Expand
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TLDR
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Debate regarding the best surgical option for type IV thoracoabdominal aortic aneurysms.
TLDR
This controversial subject is now open to discussion, and debaters have been given the challenge to clarify the evidence to justify their preferred option for repair of type IV-TAAAs. Expand
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Use of adjunct over a long period of time has produced favorable results; approximately 1 neurologic deficit saved for every 20 uses of adjunct overall in extent II aneurysms, where the effect is greatest, this increases to 1 saved per 5 uses. Expand
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Statistically significant pre- and intraoperative variables by univariate analysis that were predictive of increased risk of early death were advancing age, associated diseases that included COPD, renal artery occlusive disease, atherosclerotic heart disease, renal insufficiency, and long aortic clamp time. Expand
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