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Larzon, Thomas
Publications (10 of 21) Show all publications
McGreevy, D. T., Abu-Zidan, F. M., Sadeghi, M., Pirouzram, A., Toivola, A., Skoog, P., . . . Hörer, T. M. (2019). Feasibility and Clinical Outcome of Reboa in Patients with Impending Traumatic Cardiac Arrest. Shock
Open this publication in new window or tab >>Feasibility and Clinical Outcome of Reboa in Patients with Impending Traumatic Cardiac Arrest
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2019 (English)In: Shock, ISSN 1073-2322, E-ISSN 1540-0514Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) may improve Systolic Blood Pressure (SBP) in hypovolemic shock. It has, however, not been studied in patients with impending traumatic cardiac arrest (ITCA). We aimed to study the feasibility and clinical outcome of REBOA in patients with ITCA using data from the ABOTrauma Registry.

METHODS: Retrospective and prospective data on the use of REBOA from 16 centers globally were collected. SBP was measured both at pre- and post-REBOA inflation. Data collected included patients' demography, vascular access technique, number of attempts, catheter size, operator, zone and duration of occlusion, and clinical outcome.

RESULTS: There were 74 patients in this high-risk patient group. REBOA was performed on all patients. A 7-10Fr catheter was used in 66.7%, 58.5% were placed on the first attempt, 52.1% through blind insertion and 93.2% inflated in Zone I, 64.8% for a period of 30 to 60 minutes, 82.1% by ER doctors, trauma surgeons or vascular surgeons. SBP significantly improved to 90 mmHg following the inflation of REBOA. 36.6% of the patients survived.

CONCLUSIONS: Our study has shown that REBOA may be performed in patients with ITCA, SBP can be elevated and 36.6% of the patients survived if REBOA placement is successful.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2019
Keywords
Endovascular Resuscitation, Impending Traumatic Cardiac Arrest, REBOA, Shock, Trauma, Vascular Access
National Category
Medical and Health Sciences Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:oru:diva-79417 (URN)10.1097/SHK.0000000000001500 (DOI)31851119 (PubMedID)
Available from: 2020-01-27 Created: 2020-01-27 Last updated: 2020-02-03Bibliographically approved
Larzon, T., Roos, H., Gruber, G., Henrikson, O., Magnuson, A., Falkenberg, M., . . . Norgren, L. (2015). Editor's choice: a randomized controlled trial of the fascia suture technique compared with a suture-mediated closure device for femoral arterial closure after endovascular aortic repair. European Journal of Vascular and Endovascular Surgery, 49(2), 166-173
Open this publication in new window or tab >>Editor's choice: a randomized controlled trial of the fascia suture technique compared with a suture-mediated closure device for femoral arterial closure after endovascular aortic repair
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2015 (English)In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 49, no 2, p. 166-173Article in journal (Refereed) Published
Abstract [en]

Objectives: The aim was to investigate whether the fascia suture technique (FST) can reduce access closure time and procedural costs compared with the Prostar technique (Prostar) in patients undergoing endovascular aortic repair and to evaluate the short- and mid-term outcomes of both techniques.

Methods: In this two center trial, 100 patients were randomized to access closure by either FST or Prostar between June 2006 and December 2009. The primary endpoint was access closure time. Secondary outcome measures included access related costs and evaluation of the short- and mid-term complications. Evaluation was performed pen- and post-operatively, at discharge, at 30 days and at 6 months follow up.

Results: The median access closure time was 12.4 minutes for FST and 19.9 minutes for Prostar (p < .001). Prostar required a 54% greater procedure time than FST, mean ratio 1.54 (95% Cl 1.25-1.90, p < .001) according to regression analysis. Adjusted for operator experience the mean ratio was 1.30 (95% Cl 1.09-1.55, p = .005) and for patient body mass index 1.59 (95% Cl 1.28-1.96, p < .001). The technical failure rate for operators at proficiency level was 5% (2/40) compared with 28% (17/59) for those at the basic level (p = .003). The proficiency level group had a technical failure rate of 4% (1/26) for FST and 7% (1/14) for Prostar, p = 1.00, while corresponding rates for the basic level group were 27% (6/22) for FST and 30% (11/37) for Prostar (p = .84). There was a significant difference in cost in favor. of FST, with a median difference of (sic)800 (95% Cl 710-927, p < .001).

Conclusions: In aortic endovascular repair FST is a faster and cheaper technique than the Prostar technique.

Place, publisher, year, edition, pages
W.B. Saunders Ltd, 2015
Keywords
Endovascular aneurysm repair, Randomized controlled trial, Cost analysis, Procedure time, Fascia suture, Percutaneous closure
National Category
Cardiac and Cardiovascular Systems Surgery
Research subject
Cardiology
Identifiers
urn:nbn:se:oru:diva-44115 (URN)10.1016/j.ejvs.2014.10.021 (DOI)000350526400012 ()25549577 (PubMedID)2-s2.0-84922331265 (Scopus ID)
Available from: 2015-04-08 Created: 2015-04-08 Last updated: 2018-06-27Bibliographically approved
Skoog, P., Hörer, T. M., Nilsson, K. F. F., Norgren, L., Larzon, T. & Jansson, K. (2014). Abdominal Hypertension and Decompression: The Effect on Peritoneal Metabolism in an Experimental Porcine Study. , 47(4)
Open this publication in new window or tab >>Abdominal Hypertension and Decompression: The Effect on Peritoneal Metabolism in an Experimental Porcine Study
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2014 (English)Manuscript (preprint) (Other academic)
Abstract [en]

Objective: This study aims to investigate the abdominal metabolic response and circulatory changes after decompression of intra-abdominal hypertension in a porcine model. Design: Prospective study with controls. Setting: University hospital research laboratory.

Subjects: Three-months old domestic pigs of both sexes. Interventions: The animals were anesthetised and ventilated. Nine animals had a pneumoperitoneum-induced intra-abdominal hypertension of 30 mmHg for six hours. Twelve animals had corresponding intra-abdominal hypertension for four hours followed by decompression and were monitored for another two hours.

Measurements and Main Results: Hemodynamics, urine output and arterial blood samples were analysed. Laserdoppler measured mucosal blood flow and urine output decreased with pressure induction and showed a statistically significant restitution after decompression. Glucose, glycerol, lactate and pyruvate concentrations and lactate-pyruvate (l/p) ratio were measured by microdialysis. Both groups developed distinct metabolic changes intraperitoneally at pressure induction including an increased l/p ratio as signs of organ hypoperfusion. In the decompression group the intraperitoneal l/p ratio normalised during the second decompression hour, indicating partially restored perfusion.

Conclusions: Decompression after four hours of intra-abdominal hypertension results in restoration of intestinal blood flow and normalised intraperitoneal metabolism.

Keywords
Glycerol, Intra-abdominal hypertension, Lactate, Laser Doppler flowmetry, Microdialysis, Pyruvate
National Category
Surgery
Research subject
Surgery
Identifiers
urn:nbn:se:oru:diva-34963 (URN)
Available from: 2014-05-05 Created: 2014-05-05 Last updated: 2018-08-27Bibliographically approved
Hörer, T. M., Skoog, P., Nilsson, K. F., Oikonomakis, I., Larzon, T., Norgren, L. & Jansson, K. (2014). Intraperitoneal Metabolic Consequences of Supraceliac Aortic Balloon Occlusion in an Experimental Animal Study Using Microdialysis. Annals of Vascular Surgery, 28(5), 1286-1295
Open this publication in new window or tab >>Intraperitoneal Metabolic Consequences of Supraceliac Aortic Balloon Occlusion in an Experimental Animal Study Using Microdialysis
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2014 (English)In: Annals of Vascular Surgery, ISSN 0890-5096, E-ISSN 1615-5947, Vol. 28, no 5, p. 1286-1295Article in journal (Refereed) Published
Abstract [en]

Background: To investigate the effects of supraceliac aortic balloon occlusion (ABO) and superior mesenteric artery (SMA) occlusion on abdominal visceral metabolism in an animal model using intraperitoneal microdialysis (IPM) and laser Doppler flowmetry.

Methods: A total of 9 pigs were subjected to ABO and 7 animals were subjected to SMA occlusion for 1 hour followed by 3 hours of reperfusion. Seven animals served as controls. Hemodynamic data, arterial blood samples, urinary output, and intestinal mucosal blood flow (IBF) were followed hourly. Intraperitoneal (i.p) glucose, glycerol, lactate, and pyruvate concentrations and lactate-to-pyruvate (lip) ratio were measured using IPM.

Results: Compared with the baseline, ABO reduced IBF by 76% and decreased urinary output. SMA occlusion reduced IBF by 75% without affecting urinary output. ABO increased the i.p lip ratio from 18 at baseline, peaking at 46 in early reperfusion. SMA occlusion and reperfusion tended to increase the i.p lip ratio, peaking at 36 in early reperfusion. ABO increased the i.p glycerol concentration from 87 mu M at baseline to 579 p,M after 3 hours of reperfusion. SMA occlusion and reperfusion increased The i.p glycerol concentration but to a lesser degree.

Conclusions: Supraceliac ABO caused severe hemodynamic, renal, and systemic metabolic disturbances compared with SMA occlusion, most likely because of the more extensive ischemia-reperfusion injury. The intra-abdominal metabolism, measured by microdialysis, was affected by both ABO and SMA occlusion but the most severe disturbances were caused by ABO. The i.p lip ratios and the glycerol concentrations increased during ischemia and reperfusion and may serve as markers of these events and indicate anaerobic metabolism and cell damages respectively.

Place, publisher, year, edition, pages
Elsevier, 2014
National Category
Surgery Cardiac and Cardiovascular Systems
Research subject
Surgery
Identifiers
urn:nbn:se:oru:diva-35805 (URN)10.1016/j.avsg.2014.01.005 (DOI)000338090700030 ()24509366 (PubMedID)2-s2.0-84902795983 (Scopus ID)
Available from: 2014-08-28 Created: 2014-07-30 Last updated: 2019-03-26Bibliographically approved
Hörer, T., Skoog, P., Norgren, L., Magnuson, A., Berggren, L., Jansson, K. & Larzon, T. (2013). Intra-peritoneal microdialysis and intra-abdominal pressure after endovascular repair of ruptured aortic aneurysms. European Journal of Vascular and Endovascular Surgery, 45(6), 596-606
Open this publication in new window or tab >>Intra-peritoneal microdialysis and intra-abdominal pressure after endovascular repair of ruptured aortic aneurysms
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2013 (English)In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 45, no 6, p. 596-606Article in journal (Refereed) Published
Abstract [en]

Objectives: This study aims to evaluate intra-peritoneal (ip) microdialysis after endovascular aortic repair (EVAR) of ruptured abdominal aortic aneurysm (rAAA) in patients developing intra-abdominal hypertension (IAH), requiring abdominal decompression.

Design: Prospective study.

Material and methods: A total of 16 patients with rAAA treated with an emergency EVAR were followed up hourly for intra-abdominal pressure (IAP), urine production and ip lactate, pyruvate, glycerol and glucose by microdialysis, analysed only at the end of the study. Abdominal decompression was performed on clinical criteria, and decompressed (D) and non-decompressed (ND) patients were compared.

Results: The ip lactate/pyruvate (l/p) ratio was higher in the D group than in the ND group during the first five postoperative hours (mean 20 vs. 12), p = 0.005 and at 1 h prior to decompression compared to the fifth hour in the ND group (24 vs. 13), p = 0.016. Glycerol levels were higher in the D group during the first postoperative hours (mean 274.6 vs. 121.7 mu M), p = 0.022. The IAP was higher only at 1 h prior to decompression in the D group compared to the ND group at the fifth hour (mean 19 vs. 14 mmHg).

Conclusions: lp l/p ratio and glycerol levels are elevated immediately postoperatively in patients developing IAH leading to organ failure and subsequent abdominal decompression.

Keywords
Ruptured aortic aneurysm, Intra-abdominal hypertension, Metabolism, Microdialysis, Lactate, Pyruvate, Glycerol
National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-30189 (URN)10.1016/j.ejvs.2013.03.002 (DOI)000320745100012 ()
Available from: 2013-08-13 Created: 2013-08-13 Last updated: 2018-09-11Bibliographically approved
Jonsson, T. B., Larzon, T., Arfvidsson, B., Tidefelt, U., Axelsson, C.-G., Jurstrand, M. & Norgren, L. (2012). Adverse events during treatment limb ischemia with autologous peripheral blood mononuclear cell implant. International Journal of Angiology, 31(1), 77-84
Open this publication in new window or tab >>Adverse events during treatment limb ischemia with autologous peripheral blood mononuclear cell implant
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2012 (English)In: International Journal of Angiology, ISSN 0392-9590, E-ISSN 1827-1839, Vol. 31, no 1, p. 77-84Article in journal (Refereed) Published
Abstract [en]

Aim: Trials have reported clinical improvement and reduced need for amputation in critical limb ischemia (CLI) patients receiving therapeutic angiogenesis with stem cells. Our objective was to test peripheral stem cell therapy efficacy and safety to gain experiences for further work.

Methods: We included nine CLI patients (mean age 76.7 ±9.7). Stem cells were mobilized to the peripheral blood by administration of G-CSF (Filgrastim) for 4 days, and were collected on day five, when 30 mL of a stem cell suspension was injected into 40 points of the limb. The clinical efficacy was evaluated by assessing pain relief, wound healing and changes in ankle-brachial pressure index (ABI). Local metabolic and inflammatory changes were measured with microdialysis, growth factors and cytokine level determination. Patients were followed for 24 weeks.

Results: Four patients experienced some degree of improvement with pain relief and/or improved wound healing and ABI increase. One patient was lost to follow up due to chronic psychiatric illness; one was amputated after two weeks. Two patients had a myocardial infarction (MI), one died. One patient died from a massive mesenteric thrombosis after two weeks and one died from heart failure at week 11. Improved patients showed variable effects in cytokine-, growth factor- and local metabolic response.

Conclusion: Even with some improvement in four patients, severe complications in four out of nine patients, and two in relation to the bone marrow stimulation, made us terminate the study prematurely. We conclude that with the increased risk and the reduced potential of the treatment, peripheral blood stem cell treatment in the older age group is less appropriate. Metabolic and inflammatory response may be of value to gain insight into mechanisms and possibly to evaluate effects of therapeutic angiogenesis.

Place, publisher, year, edition, pages
Turin, Italy: Edizioni Minerva Medica, 2012
National Category
Medical and Health Sciences Clinical Medicine
Research subject
Medicine; Surgery
Identifiers
urn:nbn:se:oru:diva-22554 (URN)000301822400011 ()22330628 (PubMedID)2-s2.0-84858858355 (Scopus ID)
Available from: 2012-04-16 Created: 2012-04-16 Last updated: 2017-12-07Bibliographically approved
Larzon, T. (2012). Aspects of endovascular treatment of abdominal aortic aneurysms. (Doctoral dissertation). Örebro: Örebro universitet
Open this publication in new window or tab >>Aspects of endovascular treatment of abdominal aortic aneurysms
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2012. p. 73
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 77
National Category
Surgery
Research subject
Surgery
Identifiers
urn:nbn:se:oru:diva-25868 (URN)978-91-7668-904-2 (ISBN)
Public defence
2012-11-30, Wilandersalen, Universitetssjukhuset (USÖ), Örebro, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2012-09-17 Created: 2012-09-17 Last updated: 2017-10-17Bibliographically approved
Mayer, D., Aeschbacher, S., Pfammatter, T., Veith, F. J., Norgren, L., Magnuson, A., . . . Larzon, T. (2012). Complete replacement of open repair for ruptured abdominal aortic aneurysms by endovascular aneurysm repair: a two-center 14-year experience. Annals of Surgery, 256(5), 688-696
Open this publication in new window or tab >>Complete replacement of open repair for ruptured abdominal aortic aneurysms by endovascular aneurysm repair: a two-center 14-year experience
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2012 (English)In: Annals of Surgery, ISSN 0003-4932, E-ISSN 1528-1140, Vol. 256, no 5, p. 688-696Article in journal (Refereed) Published
Abstract [en]

Objective: To present the combined 14-year experience of 2 university centers performing endovascular aneurysm repair (EVAR) on 100% of noninfected ruptured abdominal aortic aneurysms (RAAA) over the last 32 months.

Background: : Endovascular aneurysm repair for RAAA feasibility is reported to be 20% to 50%, and EVAR for RAAA has been reported to have better outcomes than open repair.

Methods: We retrospectively analyzed prospectively gathered data on 473 consecutive RAAA patients (Zurich, 295; Örebro, 178) from January 1, 1998, to December 31, 2011, treated by an "EVAR-whenever-possible" approach until April 2009 (EVAR/OPEN period) and thereafter according to a "100% EVAR" approach (EVAR-ONLY period).Straightforward cases were treated by standard EVAR. More complex RAAA were managed during EVAR-ONLY with adjunctive procedures in 17 of 70 patients (24%): chimney, 3; open iliac debranching, 1; coiling, 8; onyx, 3; and chimney plus onyx, 2.

Results: Since May 2009, all RAAA but one have been treated by EVAR (Zurich, 31; Örebro, 39); 30-day mortality for EVAR-ONLY was 24% (17 of 70). Total cohort mortality (including medically treated patients) for EVAR/OPEN was 32.8% (131 of 400) compared with 27.4% (20 of 73) for EVAR-ONLY (P = 0.376). During EVAR/OPEN, 10% (39 of 400) of patients were treated medically compared with 4% (3 of 73) of patients during EVAR-ONLY. In EVAR/OPEN, open repair showed a statistically significant association with 30-day mortality (adjusted odds ratio [OR] = 3.3; 95% confidence interval [CI], 1.4-7.5; P = 0.004). For patients with no abdominal decompression, there was a higher mortality with open repair than EVAR (adjusted OR = 5.6; 95% CI, 1.9-16.7). In patients with abdominal decompression by laparotomy, there was no difference in mortality (adjusted OR = 1.1; 95% CI, 0.3-3.7).

Conclusions: The "EVAR-ONLY" approach has allowed EVAR treatment of nearly all incoming RAAA with low mortality and turndown rates. Although the observed association of a higher EVAR mortality with abdominal decompression needs further study, our results support superiority and more widespread adoption of EVAR for the treatment of RAAA.

Place, publisher, year, edition, pages
Philadelphia, USA: Lippincott Williams & Wilkins, 2012
Keywords
Abdominal compartment syndrome, abdominal decompression, chimney graft, debranching, endovascular repair, open abdomen treatment, open repair, ruptured abdominal aortic aneurysm
National Category
Surgery
Research subject
Surgery
Identifiers
urn:nbn:se:oru:diva-26548 (URN)10.1097/SLA.0b013e318271cebd (DOI)000311223300006 ()23095611 (PubMedID)2-s2.0-84872026584 (Scopus ID)
Available from: 2012-11-29 Created: 2012-11-29 Last updated: 2018-05-10Bibliographically approved
Mathisen, S. R., Zimmermann, E., Markström, U., Mattsson, K. & Larzon, T. (2012). Complication rate of the fascia closure technique in endovascular aneurysm repair. Journal of Endovascular Therapy, 19(3), 392-396
Open this publication in new window or tab >>Complication rate of the fascia closure technique in endovascular aneurysm repair
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2012 (English)In: Journal of Endovascular Therapy, ISSN 1526-6028, E-ISSN 1545-1550, Vol. 19, no 3, p. 392-396Article in journal (Refereed) Published
Abstract [en]

Purpose: To assess the rate of complications associated with the fascia closure technique for femoral access sites in which 18-F or 20-F sheaths were introduced during endovascular aneurysm repair (EVAR).

Methods: A retrospective analysis was done of 50 consecutive patients (41 men; median age 75 years, range 62-85) who received Excluder stent-grafts in planned percutaneous EVAR procedures from May 2006 until December 2009. The fascia closure technique was routinely used for all femoral access sites in which large bore (18-F and 20-F) introducers were employed. One patient with extremely calcified and narrowed vessels was converted to primary cutdown bilaterally after percutaneous access failed. In the 49 remaining patients, 81 femoral access sites were closed with the fascia closure technique; 17 sites with smaller 12-F introducers were closed using other techniques. Computed tomographic angiography (CTA) was performed within 30 days, at 6 months, and at 1, 2, and 3 years.

Results: Of the 81 femoral access sites closed with the fascia closure technique, only 1 patient had persistent bleeding that required an immediate cutdown and suture repair of the deep femoral artery (99.0% technical success rate). In the immediate postoperative period, 5 patients required additional interventions for bleeding (n = 2), occlusion (n = 2), or a pseudoaneurysm [92.6% 30-day technical success]. At 30 days, 11 (13.9%) of 79 access sites had pseudoaneurysms, all of which resolved within a year; none required a secondary intervention. Later surveillance scans did not detect pseudoaneurysms.

Conclusion: The fascia closure technique during EVAR is safe and has few complications. The low frequencies of pseudoaneurysms and other access site complications make the femoral closure technique a durable alternative.

Place, publisher, year, edition, pages
Thousand Oaks, USA: Sage Publications, 2012
Keywords
Abdominal aortic aneurysm, endovascular aneurysm repair, percutaneous, approach, access site, fascia closure, suture, pseudoaneurysm, bleeding
National Category
Surgery
Research subject
Surgery
Identifiers
urn:nbn:se:oru:diva-27312 (URN)10.1583/JEVT-11-3702R.1 (DOI)000306347600016 ()22788893 (PubMedID)2-s2.0-84864530309 (Scopus ID)
Available from: 2013-02-05 Created: 2013-02-05 Last updated: 2018-05-12Bibliographically approved
Hörer, T. M., Skoog, P., Pirouzram, A. & Larzon, T. (2012). Tissue plasminogen activator-assisted hematoma evacuation to relieve abdominal compartment syndrome after endovascular repair of ruptured abdominal aortic aneurysm. Journal of Endovascular Therapy, 19(2), 144-148
Open this publication in new window or tab >>Tissue plasminogen activator-assisted hematoma evacuation to relieve abdominal compartment syndrome after endovascular repair of ruptured abdominal aortic aneurysm
2012 (English)In: Journal of Endovascular Therapy, ISSN 1526-6028, E-ISSN 1545-1550, Vol. 19, no 2, p. 144-148Article in journal (Refereed) Published
Abstract [en]

Purpose: To describe our experience with a novel technique to decompress abdominal compartment syndrome after endovascular aneurysm repair (EVAR) of ruptured abdominal aortic aneurysm (rAAA).

Method: From January 2003 to April 2010, 13 patients (12 men; mean age 75 years) treated for rAAA with EVAR underwent tissue plasminogen activator (tPA)-assisted decompression for intra-abdominal hypertension. All of the patients but one had intra-abdominal pressure >20 mmHg, with signs of multiple organ failure or abdominal perfusion pressure <60 mmHg. With computed tomography guidance, a drain was inserted into the retroperitoneal hematoma, and tPA solution was injected to facilitate evacuation of the coagulated hematoma and decrease the abdominal pressure.

Results: In the 13 patients, the mean intra-abdominal pressure decreased from 23.5 mmHg (range 12-35) to 16 mmHg (range 10-28.5). A mean 1520 mL (range 170-2900) of blood was evacuated. Urine production (mean 130 mL/h, range 50-270) increased in 7 patients at 24 hours after tPA-assisted decompression; among the 5 patients in which urine output did not increase, 3 underwent hemodialysis by the 30-day follow-up. One patient did not respond with clinical improvement and required laparotomy. The 30-day, 90-day, and 1-year mortality was 38% (5/13 patients); none of the deaths was related to the decompression technique.

Conclusion: tPA-assisted decompression of abdominal compartment syndrome after EVAR can decrease the intra-abdominal pressure and could be useful in preventing multiple organ failure. It is a minimally invasive technique that can be used in selected cases but does not replace laparotomy or retroperitoneal surgical procedures as the gold standard treatments. J Endovasc Thor. 2012;19:144-148

Place, publisher, year, edition, pages
Sage Publications, 2012
Keywords
abdominal compartment syndrome, decompression, endovascular aneurysm repair, ruptured abdominal aorta aneurysm, tissue plasminogen activator
National Category
Cardiac and Cardiovascular Systems Surgery
Identifiers
urn:nbn:se:oru:diva-58683 (URN)000303644300003 ()22545876 (PubMedID)2-s2.0-84860752930 (Scopus ID)
Available from: 2017-07-12 Created: 2017-07-12 Last updated: 2018-05-15Bibliographically approved
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