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• W2947727457 abstract "Indwelling urinary catheters (Foley) are routinely placed before elective endovascular aortic repair (EVAR) for abdominal aortic aneurysm (AAA) but may be unnecessary and can potentially lead to adverse urinary events (AUE). We evaluated outcomes for those with (Foley) and without (no Foley) preoperative placement. A retrospective medical record review of all elective EVAR at a university affiliated medical center over a 5-year period was completed. Foley and no Foley groups were compared for comorbidities, operative/postoperative major adverse event, AUE, eligibility for same day discharge (SDD): uncomplicated operative/postoperative course or minor AE requiring monitoring only or recognized, treated and stabilized within 6 hours postoperatively. SPSS 24 (SPSS Inc, Chicago, Ill) was used for analysis. There were 272 elective EVAR; 86 (32%) no Foley. No Foley were more likely to be male (86%; P =.006), have coronary artery disease (45% vs 33%; P = .05), completed under conscious sedation (36% vs 8%; P < .001), with bilateral percutaneous EVAR (100% vs 90%; P = .01), and less likely to have MAOE (2% vs 10%; P = .05). The mean operative time was 171 minutes (range, 70-609 minutes) and varied by Foley (185 ± 73 vs 140 ± 37; P < .001) and operative major adverse event (250 ± 109 vs 158 ± 46; P < .001). Foley insertion during open repair was never required among the no Foley group. Postoperative AUE occurred in 10%, predominately males (93%); were less likely for no Foley versus Foley (6% vs 12%; P = .11). Time to straight catheterization or Foley reinsertion was shorter for no Foley (522 ± 269 minutes vs 1575 ± 987 minutes; P = .015). No Foley patients were more likely to be candidates for SDD (60% vs 41%; P = .003). Among Foley without major adverse event, AUE was the primary reason for SDD ineligibility in 18%. Routine preoperative Foley placement may not be necessary for all patients. AUEs were lower among no Foley. While this was not statistically different from Foley, there were no additional untoward sequelae associated with postoperative Foley insertion on an as needed basis. AUE can be identified and treated earlier for no Foley, potentially allowing SDD. This is particularly relevant since AUE associated with Foley may limit SDD in up to 18% of potential candidates." @default.
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• W2947727457 date "2019-06-01" @default.
• W2947727457 modified "2023-09-30" @default.
• W2947727457 title "IP077. Need for Routine Preoperative Insertion of Indwelling Urinary Catheter Before Endovascular Aortic Repair of Abdominal Aortic Aneurysm" @default.
• W2947727457 doi "https://doi.org/10.1016/j.jvs.2019.04.162" @default.
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