Vascular Surgery Thoracoabdominal Aneurysm Repair: Lessons Learned on a General Vascular Surgery Unit

Purpose: Much has been learned in the past thirty years regarding the management of patients with thoracoabdominal aortic aneurysms (TAA), especially from the seminal contributions of Crawford and associates at Baylor. As a result of the efforts of Dr. Crawford and a few others, the management of these patients has spread from those centers specializing in the care of patients with TAAs to institutions that perform a wide breadth of general vascular surgery. This change in settings might be accompanied by a change in the morbidity and mortality expected with the repair of TAAs, and the risk factors identified by Crawford and associates might not apply to other institutions. Therefore, the authors conducted a retrospective review of their experience to analyze the surgical results obtained when repairing TAAs at an institution that performs a large breadth of general vascular surgery but does not specifically specialize in the repair of TAAs. In addition, the authors determined whether any of 207 clinical variables was statistically associated with in-hospital mortality, ischemic spinal cord injury, or renal failure and quantitated the strength of any such association by statistical analysis