Scientific article
Open access

Activated coagulation during open and endovascular abdominal aortic aneurysm repair

Published inJournal of vascular surgery, vol. 43, no. 6, p. 1124-1129
Publication date2006-06
First online date2006-06-07

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.

  • Aged
  • Analysis of Variance
  • Antithrombin III
  • Aortic Aneurysm, Abdominal / surgery
  • Blood Coagulation / physiology
  • Blood Coagulation Tests
  • Blood Vessel Prosthesis Implantation / methods
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Fibrin Fibrinogen Degradation Products / metabolism
  • Humans
  • Infant, Newborn
  • Male
  • Peptide Hydrolases / blood
  • Prospective Studies
  • Statistics, Nonparametric
Affiliation Not a UNIGE publication
Citation (ISO format)
ENGLBERGER, Lars et al. Activated coagulation during open and endovascular abdominal aortic aneurysm repair. In: Journal of vascular surgery, 2006, vol. 43, n° 6, p. 1124–1129. doi: 10.1016/j.jvs.2006.02.029
Main files (1)
Article (Published version)
ISSN of the journal0741-5214

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