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Related Concept Videos

Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...

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Related Experiment Video

Updated: Jul 12, 2026

A New Murine Model of Endovascular Aortic Aneurysm Repair
08:51

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Published on: July 7, 2013

"Fast-track" abdominal aortic aneurysm repair.

Dipankar Mukherjee1

  • 1Inova Fairfax Hospital, Falls Church, VA, USA.

Vascular and Endovascular Surgery
|October 7, 2003
PubMed
Summary

A fast-track approach to open abdominal aortic aneurysm (AAA) repair using limited incisions and specialized pathways significantly shortens hospital stays. This method offers benefits comparable to endovascular repair, avoiding concerns about stent-graft durability.

Area of Science:

  • Vascular Surgery
  • Surgical Innovation
  • Patient Care Pathways

Background:

  • Open repair of abdominal aortic aneurysms (AAA) is evolving towards less invasive techniques.
  • Patient care pathways aim to reduce hospital stays and improve recovery.
  • Traditional open AAA repair often involves longer recovery periods.

Purpose of the Study:

  • To evaluate a "fast-track" hospital care pathway for open infrarenal abdominal aortic aneurysm (AAA) repair.
  • To assess the feasibility and outcomes of minimally invasive open AAA repair.
  • To compare the benefits of this approach with endovascular repair.

Main Methods:

  • Implementation of a "fast-track" protocol for 30 patients with infrarenal AAA.
  • Utilized limited retroperitoneal incisions (10-15 cm) for AAA exposure.

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  • Employed self-retaining retractors, specialized vascular instruments, and prosthetic graft endoaneurysmorrhaphy.
  • Incorporated oral metoclopramide and patient-controlled epidural analgesia for pain management and early mobilization.

    • Main Results:

    • Achieved excellent anatomic exposure with an average operative time of 175 minutes.
    • Patients ambulated and consumed a diet on postoperative day 1.
    • Average hospital stay was 3.6 days (range: 3-7 days), with no readmissions for AAA repair-related issues.
    • Reported a 30-day mortality rate of 3.3% (one death due to splenic injury) and one ureter injury requiring repair.

    Conclusions:

    • "Fast-track" open AAA repair using limited incisions can achieve outcomes similar to endovascular repair, including shorter hospital stays and earlier recovery.
    • This approach avoids concerns associated with endovascular stent-graft durability and follow-up imaging.
    • The technique is applicable to most patients with infrarenal AAAs and is readily mastered by vascular surgeons.