Analysis of the adverse events in the perioperative period in high-risk patients treated surgicalyl and endovasularly for infrarenal aortic aneurysm

Aim of the study
Demonstration of differences in patient preparation for vascular prosthesis vs. stent graft implantation in AAA treatment, assessment of adverse events, comparison of subjective assessment of perioperative quality of life using the VAS scale, and the level of pain sensation.

Material and methods
Out of 226 patients treated in 2014, 146 met the eligibility criteria, of whom 85 qualified for surgery and 61 for stent-graft implantation. The operation was performed under general anaesthesia, and the stent graft implantation was performed under local anaesthesia with intravenous sedation. The patients were divided into 2 groups: group 1 patients were operated on, and group 2 patients were treated intravascularly. Group 1 was divided into 2 subgroups: group 1 A – aorto-aortic prosthesis, n = 49; group 1 B – aortoiliac bifurcation, n = 36.

Results
The length of ICU stay in patients after surgery was significantly shorter. The mean blood loss was significantly greater in the operated patients. In both groups there was a decrease in haemoglobin levels and a decrease in blood platelets levels. Complications related to wound healing occurred in 7 patients. Eight patients had pressure ulcers I and II degree, and in one III degree.

Conclusions
A shorter hospital stay after implantation of the stent graft was noticed. The same increase in Hb levels and increase in leukocytosis was observed in the examined patients. Despite the higher level of pain after surgery, an increase in the subjective assessment of quality of life was observed.