THE INFLUENCE OF OPEN SURGICAL AND ENDOVASCULAR ANEURYSM REPAIR OF AN ABDOMINAL AORTIC ANEURYSM ON HAEMOSTATIC SYSTEM ASSESSED BY ROTEM® TEST

Ekrem Ismani, Sanja Sarac, Hanife Rustemi Ahmeti, Dragan Sekulic, Meri Shorova

Abstract

Introduction. The disturbances in hemostasis system in open surgical repair (OR) and endovascular repair (EVAR) of an abdominal aortic aneurysm (AAA), may influence on the perioperative and early postoperative period by inducing serious complications. The aim of this study was to compare the impact of OR of AAA and EVAR on hemostatic system assessed by rotational thromboelastometry (ROTEM®) test. Methods: The study included 60 patients who underwent elective AAA surgery, divided into two groups (OR and EVAR group - 30 patients in each group). The ROTEM® test was performed in 4 points. Three ROTEM® tests were performed: extrinsically activated assay with tissue factor (EXTEM), intrinsically activated test using kaolin (INTEM), and extrinsically activated test with tissue factor and the platelet inhibitor cytochalasin D (FIBTEM). Results: No significant difference in age, gender and diameter of AAA between groups was found. The time required for the procedure was significantly longer in OR group and loss of blood was greater in OR group than in EVAR group (p<0.001). Extem CT, Extem CFT and Extem angle alpha, show significant differences between groups during the measuring time. Conclusion: The disorders of hemostatic parameters assessed by ROTEM® test are present in both OR and EVAR, which are more pronounced in OR of AAA. Vigilant monitoring of hemostatic parameters evaluated by ROTEM® can help in administration of adequate and target therapy in patients undergo EVAR and OR of AAA.

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