M. D. Balceniuk1, P. Zhao1, L. Cybulski1, M. C. Stoner1 1University Of Rochester,Division Of Vascular Surgery,Rochester, NY, USA
Introduction:
Metabolic syndrome (MetS) is a constellation of five clinical and laboratory findings associated with adverse cardiovascular outcomes as well as wound healing outcomes. MetS has also been reported to be associated with type 2 endoleak following endovascular aneurysm repair (EVR). We report impact of modified metabolic syndrome (mMetS) on groin access complications following EVR.
Methods:
The Vascular Quality Initiative (VQI) endovascular aortic repair module 2008-2016 was evaluated. MetS classification was modified based on the variables available within the VQI registry. Patients were considered to have mMetS (study group) if they had all three diagnosis of body mass index (BMI) >30, hypertension and diabetes. Patients missing one or more of these diagnoses were placed in the non-mMetS (control group) group. Access site complications were evaluated between patients with mMetS and those without.
Results:
Over 30,000 patients were included in the analysis, with over 3000 patients met the criteria for mMetS (Table). The non-metabolic group were significantly older and had higher rates of females and white race. The mMetS cohort had higher rates of coronary artery disease, chronic obstructive pulmonary disease and congestive heart failure. Groups were similar regarding access type for percutaneous (65% versus 65%, p=0.987). Surgical site infections (SSI) were significantly higher in the mMetS group (24 (0.783%) vs 87 (0.317%), p?0.001), whereas no difference was noted for access site hematoma between groups. Additionally, sub-group regression analysis of the mMetS cohort identified open access type to be a significant predictor of post-operative SSI (p=0.028).
Conclusion:
Our data demonstrates that there is a significantly higher rate of SSI in patients with mMetS following EVR. We have also shown that percutaneous access in patients with modified metabolic syndrome significantly reduced the incidence of post-operative SSI. These data suggest that percutaneous access should be attempted in EVR patients with metabolic syndrome to mitigate the risk of open femoral access SSI.
