Which dose abdominal compartment syndrome occur after endovascular repair of ruptured infra-renal abdominal aortic aneurysm or not?

No. 349 Which dose abdominal compartment syndrome occur after endovascular repair of ruptured infrarenal abdominal aortic aneurysm or not? J. Nishimura, Y. Koike, S. Hase, N. Hosaka, M. Yamasaki, N. Moriya, H. Nishimaki; Department of Interventiona Radiology, Kawasaki Saiwai Hospital, Kawasaki, Japan; Department of Cardiovascular surgery, St. Marianna Medical University, Kawasaki, Japan Purpose: Abdominal compartment syndrome (ACS) have been increasingly recognized as significant causes of mortality in patients with endovascular repair (EVAR) of ruptured infrarenal abdominal aortic aneurysms (rAAAs). If there is high rate of falling into the ACS in the patient with rAAA, EVAR with the procedure of leak reduction and continuous decompression surgery of intra-abdominal pressure are able to be performed. Otherwise, the shock index (SI), defined as the ratio of heart rate to systolic blood pressure, is a simple marker for situation in emergent patients. This study is presented to determine whether the SI is a useful marker for ACS in patients with EVAR of rAAAs. Materials and Methods: In 14 cases with rAAAs, 12 Men and 2 women, mean age 77.2 6.5, EVAR were performed emergency in our institution between March in 2012 and July in 2013. SI calculated from heart rate and systolic blood pressure just before putting the patients under an anesthetic. SI was analyzed between patients with ACS and without ACS. Results: Intraoperative immediate technical success were obtained in all cases. 4 patients fall into the ACS, 2 patients of them died, and reminded 2 patients could leave hospital on foot. SI of patients with ACS and without ACS were 1.86 0.30 (1.44 2.08) and 1.28 0.45 (0.67 1.86), respectively. There is significant difference between SI with ACS and without ASC (P o 0.05). 4 patients died in our hospital after EVAR. SI of the death and survive cases were 1.86 0.23 (1.55 2.08) and 1.29 0.43 (0.67-1.86), respectively. Also, there is significant difference between SI with death and survive cases (P o 0.05). All patients with SI less than 1.4 could be survive, and all patient more than 2.0 died. There is the same trend about ACS between patients in our institusion with EVAR of rAAA and ruptured solitary iliac artery’s aneurysm. Conclusion: SI is simple and useful marker for ACS in patients with EVAR of rAAAs. When SI is over 1.4, there is possibility patient falling into ACS, the procedure for leak control during EVAR and decompression of the abdomen after EVAR are considered to be prepared.