Systemic Complications of Vascular Disease and Intervention
Systemic complications of vascular disease and intervention organized by threatened organ system: heart, brain, kidney, lung, spinal cord, venous system, and cognition. The chapter ties each complication to its preventable patient, operative, or device driver.
Consult corner: A bedside consult-style discussion focused on what the clinician should decide next and what not to overinterpret.
Choose the hostsOrgan-system map for systemic complications
Systemic complications after vascular intervention rarely respect specialty boundaries. The same patient may enter the operating room with diffuse atherosclerosis, renal vulnerability, chronic lung disease, frailty, and competing antithrombotic indications. A useful mental map starts with the threatened organ systems—heart, brain, kidney, lung, spinal cord, venous system, and cognition—then asks which are vulnerable because of the patient, which because of the operation, and which because of the perioperative plan. Contemporary perioperative cardiovascular guidance frames preoperative assessment around urgency, functional capacity, and condition-specific cardiac risk, with additional testing reserved for situations where the result would alter anesthesia, monitoring, or the operative approach; this is especially important in vascular surgery, where urgent limb- or life-saving operations may proceed without the luxury of elective workup.
Aortic surgery concentrates several systemic hazards in one exposure. Open thoracoabdominal aneurysm repair series from large-volume centers show that even with multimodal protective adjuncts, operative mortality remains in the high single-digit range, permanent paraplegia or paraparesis occurs in roughly one in twenty patients, and permanent dialysis-requiring renal failure occurs at a similar low single-digit frequency. Pooled modern descending thoracic and thoracoabdominal aneurysm data suggest permanent spinal cord injury in roughly one in thirty patients overall, with open repair carrying modestly higher permanent spinal cord injury risk than endovascular repair. These figures should shape consent, case selection, staging decisions, rescue planning, and the threshold for postoperative neurologic and renal surveillance.
Pulmonary vulnerability deserves the same deliberate attention as cardiac risk. Chronic obstructive pulmonary disease is more prevalent in patients with abdominal aortic aneurysm than in matched non-aneurysm controls and is independently associated with increased perioperative mortality after both open and endovascular aneurysm repair. Open abdominal aortic surgery has a dedicated literature linking postoperative pulmonary complications with incidence, predictors, and mortality, while broader risk tools such as ARISCAT and vascular-specific registry models can help identify patients who require intensified respiratory planning rather than routine postoperative observation.
Respiratory risk is not confined to open repair. An international observational study of ventilation practice found postoperative pulmonary complications at substantially elevated rates after aortic surgery compared with most other surgical specialties, with severe pulmonary complication rates in the aortic subgroup near one in ten. For the vascular surgeon, this supports a preoperative and intraoperative conversation about ventilation strategy, extubation readiness, postoperative monitoring location, mobilization, and early recognition of respiratory deterioration rather than treating pulmonary complications as an anesthetic issue alone.
The organ-system map should also include blood loss, transfusion, anemia, and their downstream effects. In elective open abdominal aortic aneurysm repair, perioperative red-blood-cell transfusion exposure was independently associated with increased postoperative composite morbidity and mortality after adjustment, and in open aortic and vena-caval surgery postoperative anemia within defined hemoglobin thresholds was independently associated with acute kidney injury. These observations do not make transfusion inappropriate when oxygen delivery is threatened, but they do make blood conservation, hemostasis, cell salvage where used, and postoperative red-cell management part of systemic complication prevention rather than administrative details.
Cardiac, neurologic, and renal pathways
Cardiac complications after vascular surgery are often silent, and that is the central practical lesson. In the POISE noncardiac surgery cohort, about two-thirds of perioperative myocardial infarctions occurred without ischemic symptoms, and 30-day mortality was substantially higher whether the infarction was symptomatic or not. Myocardial injury after noncardiac surgery is now framed around postoperative high-sensitivity troponin elevation above the assay 99th percentile attributed to ischemia; it does not require chest pain or electrocardiographic changes and is independently associated with 30-day mortality. The failure mode is therefore waiting for classic angina in a sedated, analgesic-treated, or delirious vascular patient.
For vascular surgeons, myocardial injury is not only a cardiac endpoint. In vascular surgery patients, postoperative myocardial injury detected by elevated troponin is independently associated with major non-cardiac complications at 30 days, including renal, neurologic, infectious, and bleeding complications, while preoperative cardiac biomarker levels did not predict that non-cardiac complication burden. A postoperative troponin rise should therefore trigger a broad bedside reassessment: hemodynamics, bleeding, oxygenation, renal function, neurologic status, infection, and medication reconciliation, not simply a cardiology label placed in the chart.
Perioperative atrial fibrillation is another junction between cardiac and systemic risk. A vascular-surgery systematic review synthesized atrial fibrillation prevalence, postoperative incidence, and associations with downstream cardiovascular morbidity across open and endovascular interventions. AAA-repair cohort data suggest that even transient new-onset perioperative atrial fibrillation is associated with elevated late mortality compared with sinus-rhythm controls, and descending-aortic repair data link new-onset atrial fibrillation with procedure-specific factors such as cross-clamp time and pre-existing pulmonary disease, as well as length-of-stay and complication implications. New postoperative atrial fibrillation should not be dismissed as a temporary telemetry nuisance.
Neurologic complications require mechanism-based thinking. The tissue-based definition of ischemic stroke recognizes central-nervous-system infarction demonstrated by imaging, pathology, or persistent clinical findings, separating stroke from transient ischemic attack without infarction and from silent infarction; at the bedside, the surgeon should document whether the diagnosis rests on clinical findings, imaging, or both. A mechanistic approach separates embolic, hemodynamic, and lacunar pathways, and perioperative stroke prevention reviews emphasize intraoperative hypotension, new-onset atrial fibrillation, and interruption of antithrombotic therapy as modifiable contributors, while prior stroke remains the strongest non-modifiable risk factor.
The timing of perioperative stroke matters because early recognition is prognostically important. A cohort analysis of perioperative stroke after noncardiac surgery found that stroke timing relative to the operation correlates with mortality, with strokes recognized intraoperatively or in the immediate postoperative window carrying the highest short-term mortality. Patent foramen ovale is consistently associated with elevated perioperative stroke risk after noncardiac surgery, with the largest pooled adjusted odds ratios reported in noncardiac thoracic, vascular, and general surgery; however, absolute stroke rates remain low and routine preoperative PFO screening is not supported. The practical compromise is targeted suspicion and mechanism-aware workup, not indiscriminate screening.
Renal injury is common enough after vascular intervention that it should be anticipated rather than discovered late. External validation of preoperative AKI prediction models in more than thirteen thousand noncardiac surgical patients found that only a minority of models achieved fair discrimination after recalibration and that AKI still occurred in roughly one in twenty patients despite contemporary care. In vascular cohorts, KDIGO-defined AKI occurs after elective EVAR in a clinically meaningful minority and is associated with longer hospital stay and incomplete renal recovery at discharge, while broader AAA-repair data identify ruptured presentation and preoperative renal dysfunction as key risk factors and show a mortality penalty with severe postoperative AKI.
The kidney pathway differs by procedure. Complex endovascular aneurysm repair can produce early AKI and sustained long-term estimated glomerular filtration-rate decline in a non-trivial proportion of patients, while pararenal aneurysm repair data distinguish AKI contributions from suprarenal clamping in open repair and renovisceral catheter-time exposure in endovascular repair. After elective open abdominal aortic surgery, AKI may be highly prevalent, with roughly three in five patients affected overall and one in four developing KDIGO stage 2 or 3 injury within 24 hours; routine perioperative parameters such as cystatin C or creatinine, urine osmolality, and early urine output outperformed several novel biomarkers for early prediction.
Delirium, VTE, and antithrombotic context
Postoperative delirium is a vascular complication, not just a geriatric syndrome. In vascular surgery cohorts, reported delirium incidence ranges from about five percent to nearly forty percent, with open aneurysm repair, emergency operations, advanced age, dementia, renal impairment, and major amputation among the strongest reported risk modifiers. In a contemporary open abdominal aortic aneurysm repair cohort, delirium occurred in roughly one-third of patients and was associated with markedly longer hospital and intensive-care stays and substantially higher 90-day mortality. These data justify active screening and prevention in high-risk vascular patients rather than waiting for agitation to declare the diagnosis.
- Build a multicomponent delirium-prevention bundle into the vascular postoperative order set for older or otherwise high-risk patients, with explicit avoidance of routine benzodiazepine sedation and review of anticholinergic exposure.
- Trigger
- Older adults and other delirium-vulnerable patients undergoing surgery, including major vascular procedures.
- Branch / Endpoint
- Multicomponent bundles reduce but do not eliminate delirium; identification and treatment of the precipitating cause remain essential when delirium occurs.
Citation - Treat older vascular patients facing open aortic repair, emergent operations, or limb amputation as high-delirium-risk by default, and apply a multicomponent prevention bundle from admission, not after symptoms emerge.
- Trigger
- Adults undergoing open and endovascular vascular operations across the included cohorts.
- Branch / Endpoint
- Pooled estimates are heterogeneous because delirium ascertainment, screening tools, and case mix vary across the included studies.
Citation - For each vascular admission, choose mechanical or pharmacologic VTE prophylaxis after a documented thrombosis-versus-bleeding risk balance, and reassess after reoperation, hemorrhage, or significant change in renal function.
- Trigger
- Adults undergoing surgery in European practice settings, applied analogously to vascular procedures.
- Branch / Endpoint
- The update is an executive summary; specific drug-dose-duration choices vary by procedure and local formulary, and direct evidence for VTE prophylaxis in vascular surgery remains limited.
Citation - The 2019 American Society of Hematology guideline panel on venous thromboembolism prevention in hospitalized surgical patients issued recommendations stratified by surgical risk category covering mechanical and pharmacologic prophylaxis options, duration of prophylaxis, and special-population considerations including patients undergoing major abdominal surgery.
- Trigger
- Apply venous thromboembolism prophylaxis in hospitalized surgical patients, selecting mechanical versus pharmacologic options by surgical risk category.
- Branch / Endpoint
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Citation - For each anticoagulated vascular patient, write a single perioperative anticoagulation plan that states the indication, the planned hold, whether bridging is used and why, the intraoperative anticoagulation strategy, and the resumption trigger after surgery.
- Trigger
- Adults on chronic anticoagulant or antiplatelet therapy presenting for elective or urgent surgery.
- Branch / Endpoint
- ACCP CHEST 9th edition predates direct oral anticoagulant data and contemporary bridging trial evidence; updated society documents have refined bridging thresholds, but the framework of indication-versus-bleeding remains current.
Citation - Consider dual pathway therapy with rivaroxaban 2.5 mg twice daily plus aspirin for selected PAD patients after revascularization, balancing the predicted limb and cardiovascular benefit against the documented bleeding cost.
- Trigger
- Adults with symptomatic peripheral artery disease undergoing lower-extremity revascularization.
- Branch / Endpoint
- VOYAGER excluded patients at very high bleeding risk; absolute event rates and benefit-harm balance depend on individual bleeding history, prior intracranial events, and renal function.
Citation
Delirium prevention is most effective when treated as a bundle. The ASER and Perioperative Quality Initiative consensus supports multicomponent pathways addressing orientation, sleep, early mobility, hydration, sensory aids, and minimization of deliriogenic medications, particularly benzodiazepines and anticholinergics. Anesthetic technique alone is not a dependable solution: the RAGA randomized trial in older hip-fracture patients found no significant difference in delirium within seven days between regional and general anesthesia, a result that cautions against overpromising delirium prevention by anesthesia choice alone in vascular populations.
Vascular-specific prevention efforts should begin before admission when time permits. In elderly patients undergoing elective abdominal aortic aneurysm repair, a multimodal prehabilitation pathway combining delirium risk assessment, home-based exercise, nutritional optimization, anemia correction, and comprehensive geriatric assessment was associated with shorter hospital stay and a non-significant trend toward lower postoperative delirium and lower 30-day mortality, with the largest absolute delirium reduction in the open repair subgroup. The appropriate teaching point is not that prehabilitation guarantees delirium prevention, but that delirium risk can be operationalized into preoperative optimization, ward routines, and discharge planning.
Venous thromboembolism prophylaxis after vascular surgery must be individualized because procedure risk varies widely. A vascular-surgery meta-analysis found limited direct evidence for pharmacologic prophylaxis, with the highest VTE rates concentrated in open aortic reconstruction and the lowest rates in routine peripheral bypass and endovascular procedures. A contemporary major vascular surgery cohort found VTE in roughly one in thirty patients overall, with higher risk after thoracic endovascular and open aortic operations than after elective infrarenal EVAR; more than one-third of events occurred after discharge within 90 days, and delaying postoperative anticoagulant or antiplatelet therapy beyond four days more than doubled VTE odds.
Guidelines support a stratified prophylaxis approach rather than a single vascular-surgery rule. The 2024 European perioperative VTE prophylaxis update emphasizes balancing patient-level thrombosis risk, bleeding risk, and procedure exposure, using mechanical prophylaxis when pharmacologic prophylaxis is contraindicated and reassessing as bleeding risk evolves. The 2019 American Society of Hematology surgical guideline similarly structures prophylaxis choices around surgical risk category, mechanical and pharmacologic options, duration, and special populations including major abdominal surgery. For trainees, the key habit is daily reassessment: an appropriate decision on the day of aortic surgery may be wrong once bleeding stabilizes, mobility improves, or a new thrombotic risk appears.
Antithrombotic decisions sit at the center of systemic complication prevention. Perioperative anticoagulant management should balance the thrombotic indication, surgical bleeding risk, and the patient’s ability to tolerate interruption, with bridging reserved for patients whose thrombotic indication outweighs perioperative bleeding harm. Dual antiplatelet therapy after coronary intervention is similarly a balance between ischemic and bleeding risk, with longer duration favored after drug-eluting stent placement in low-bleeding-risk patients and shorter duration acceptable when bleeding risk dominates; newer guidance and stent platforms have refined minimum intervals, so local current guidance should be checked before holding therapy.
Longer-term vascular antithrombotic therapy also changes the systemic risk conversation. In stable atherosclerotic cardiovascular disease, low-dose rivaroxaban plus aspirin reduced major adverse cardiovascular events compared with aspirin alone and produced a particularly large reduction in major adverse limb events in the PAD subgroup, at the cost of increased major bleeding. After lower-extremity revascularization for symptomatic PAD, VOYAGER PAD showed that low-dose rivaroxaban added to aspirin reduced a composite including acute limb ischemia, major vascular amputation, myocardial infarction, ischemic stroke, and cardiovascular death, with a modest bleeding increase. These regimens are not automatic discharge defaults; they require individualized bleeding-risk review, renal-function review, and reconciliation with any need for dual antiplatelet therapy or anticoagulation for atrial fibrillation.
Clinical integration, follow-up, and evidence boundaries
The practical integration begins with a preoperative problem list that is smaller than the comorbidity list but more actionable. For each patient, identify the organ systems most likely to fail, the operative feature that threatens them, and the monitoring or rescue plan that would change management. A frail patient undergoing open aneurysm repair may need delirium prevention, pulmonary planning, renal surveillance, and cardiac monitoring; a patient undergoing lower-extremity revascularization may need antithrombotic strategy and limb-event prevention; a descending-aortic repair patient may need explicit planning for spinal cord, renal, pulmonary, and atrial-fibrillation pathways. This approach follows the perioperative principle that testing and evaluation should be used when results change anesthesia, monitoring, or operative strategy, not merely to complete a checklist.
Postoperative surveillance should match the failure modes that are common and silent. Myocardial injury and infarction may occur without symptoms, stroke may be difficult to detect during anesthesia or early recovery, AKI may evolve before creatinine stabilizes, delirium may present as hypoactivity rather than agitation, and VTE may occur after discharge. The implication is that ward orders, ICU handoff, and discharge instructions should explicitly include neurologic checks when appropriate, renal-function and urine-output review, delirium screening, respiratory assessment, VTE prevention and symptom education, and medication restart plans.
Follow-up is part of systemic complication care. A postoperative atrial fibrillation episode requires reassessment of stroke risk and bleeding risk rather than automatic dismissal once sinus rhythm returns; meta-analysis suggests anticoagulation after new perioperative atrial fibrillation is associated with lower stroke risk compared with no anticoagulation, but the absolute benefit and bleeding trade-off depend on baseline thromboembolic risk and the evidence is largely observational. Renal follow-up matters after EVAR, complex endovascular repair, and open aortic surgery because incomplete recovery at discharge and longer-term eGFR decline are documented in vascular cohorts.
- Population
- Adults undergoing noncardiac surgery, including vascular and endovascular interventions.
- Intervention
- Document urgency, functional capacity, and the specific cardiac conditions present before ordering noninvasive testing; if no test result would alter the plan, proceed and use postoperative troponin surveillance and structured handoff instead.
- Comparator
- The 2024 multisociety perioperative cardiovascular guideline frames preoperative evaluation as a structured assessment of urgency, functional capacity, and condition-specific cardiac risk, with additional testing reserved for situations where the result would change anesthesia, monitoring, or operative approach.
- Key result
- Risk-stratification thresholds and testing indications are recommendations, not mandates; emergent vascular operations may proceed without elective workup.
- Limitation
- Population
- Adults at elevated cardiovascular risk undergoing major noncardiac surgery, including aortic and lower-extremity revascularization.
- Intervention
- Order postoperative troponin in elevated-risk vascular patients, interpret values against the local assay 99th percentile, and treat MINS as a vascular-disease decompensation requiring medical optimization rather than as an incidental laboratory abnormality.
- Comparator
- Myocardial injury after noncardiac surgery (MINS) is defined by postoperative high-sensitivity troponin elevation above the assay 99th percentile attributed to ischemia, and is frequently asymptomatic yet independently associated with 30-day mortality.
- Key result
- Troponin thresholds depend on the specific assay; MINS does not require ischemic symptoms or ECG changes, so isolated elevations should not be dismissed.
- Limitation
- Population
- Adults developing new atrial fibrillation in the perioperative period after noncardiac surgery.
- Intervention
- When new atrial fibrillation appears after a vascular operation, document CHA₂DS₂-VASc, review bleeding history and surgical-site bleeding risk, and decide explicitly whether and when to start anticoagulation rather than deferring the decision to outpatient follow-up.
- Comparator
- No anticoagulation
- Key result
- A systematic review and meta-analysis of anticoagulation use after new perioperative atrial fibrillation found that initiating anticoagulant therapy in this population is associated with a lower stroke risk compared with no anticoagulation, with the absolute benefit and bleeding trade-off depending on baseline thromboembolic risk
- Limitation
- Most contributing studies are observational; randomized data on anticoagulation versus no anticoagulation specifically after perioperative atrial fibrillation are limited.
Citation- Population
- Surgical patients, including vascular surgery, at risk of postoperative acute kidney injury.
- Intervention
- Evidence summary; see key result.
- Comparator
- A 2022 Clinical Journal of the American Society of Nephrology synthesis of postoperative acute kidney injury defined the contemporary KDIGO-aligned diagnostic framework, summarized procedure-specific incidence patterns including vascular surgery, and articulated structured perioperative bundles for AKI prevention with their evidence-quality grading.
- Key result
- Cross-surgical synthesis; incidence patterns and recommendations are not specific to vascular surgery.
- Limitation
- Population
- Adults undergoing open and endovascular vascular procedures included across the meta-analysis cohorts.
- Intervention
- Default to individualized VTE risk assessment for each vascular admission rather than reflexive prophylaxis: prioritize prophylaxis in open aortic and amputation cases and reassess after bleeding events or reoperations.
- Comparator
- A meta-analysis of venous thromboembolism prophylaxis trials and cohorts in vascular surgery found that direct evidence for pharmacologic prophylaxis is limited, with the highest VTE rates concentrated in open aortic reconstruction and the lowest in routine peripheral bypass and endovascular procedures.
- Key result
- The pooled effect estimate was wide and not statistically significant; the absolute VTE risk varies substantially by operation and patient factors.
- Limitation
Discharge after vascular surgery should reconcile competing antithrombotic goals. The surgeon must account for coronary stent history, chronic anticoagulation indications, new atrial fibrillation, recent revascularization, bleeding events, renal function, and wound or access-site status. Evidence supporting low-dose rivaroxaban plus aspirin in stable atherosclerotic disease and after lower-extremity revascularization is strong for selected patients, but both COMPASS and VOYAGER PAD require attention to bleeding risk and trial exclusions when translating results to an individual patient.
The evidence base has important boundaries. Several vascular-systemic complication estimates come from single-center cohorts, observational registries, administrative datasets, or meta-analyses with heterogeneous definitions and ascertainment. AKI definitions commonly use KDIGO creatinine criteria, delirium rates vary with screening method, perioperative stroke mechanisms can remain probabilistic despite workup, and VTE estimates differ by procedure and post-discharge capture. These limitations should not paralyze decision-making; they should make surgeons explicit about uncertainty, procedure-specific risk, and the need to reassess as physiology changes.
The safest vascular practice treats systemic complications as foreseeable pathways rather than isolated adverse events. A postoperative troponin elevation, new delirium, small creatinine rise, transient atrial fibrillation, delayed chemical prophylaxis, or early respiratory decline should prompt active reassessment because each may signal a broader trajectory of harm. For trainees, the discipline is to connect the event to mechanism, decide what must be ruled out immediately, restart or withhold antithrombotics deliberately, communicate risk at handoff, and arrange follow-up for problems that outlast the incision.
References
- 1.
- 2.
- 3.
- 4.
- 5.
- 6.
- 7.
- 8.
- 9.
- 10.
- 11.
- 12.
- 13.
- 14.
- 15.
- 16.
- 17.
- 18.
- 19.
- 20.
- 21.
- 22.Perioperative myocardial injury is associated with increased postoperative non-cardiac complications in patients undergoing vascular surgery: a post hoc analysis of a randomised clinical pilot trial DOI: 10.1186/s13741-023-00350-yPubMed-indexed articleRandomized controlled trial2023
- 23.Characteristics and short-term prognosis of perioperative myocardial infarction in patients undergoing noncardiac surgery: a cohort study. 2011.PubMed-indexed articleRegistry / cohort2011
Characteristics and short-term prognosis of perioperative myocardial infarction in patients undergoing noncardiac surgery: a cohort study. 2011. doi:10.7326/0003-4819-154-8-201104190-00003.
- 24.Evidence-based management of anticoagulant therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. 2012.PubMed-indexed articleClinical practice guideline2012
Evidence-based management of anticoagulant therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. 2012. doi:10.1378/chest.11-2297.
- 25.An updated definition of stroke for the 21st century: a statement for healthcare professionals from the American Heart Association/American Stroke Association. 2013.PubMed-indexed article2013
An updated definition of stroke for the 21st century: a statement for healthcare professionals from the American Heart Association/American Stroke Association. 2013. doi:10.1161/str.0b013e318296aeca.
- 26.2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet Therapy in Patients With Coronary Artery Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines: An Update of the 2011 ACCF/AHA/SCAI Guideline for Percutaneou. Circulation. 2016.PubMed-indexed articleClinical practice guideline2016
2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet Therapy in Patients With Coronary Artery Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines: An Update of the 2011 ACCF/AHA/SCAI Guideline for Percutaneou. Circulation. 2016. doi:10.1161/cir.0000000000000404.
- 27.
- 28.American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Postoperative Delirium Prevention. Anesthesia and analgesia. 2020.PubMed-indexed articleClinical practice guideline2020
American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Postoperative Delirium Prevention. Anesthesia and analgesia. 2020. doi:10.1213/ane.0000000000004641.
- 29.
- 30.A meta-analysis and systematic review of venous thromboembolism prophylaxis in patients undergoing vascular surgery procedures. Journal of vascular surgery. Venous and lymphatic disorders. 2020.PubMed-indexed articleMeta-analysis / systematic review2020
A meta-analysis and systematic review of venous thromboembolism prophylaxis in patients undergoing vascular surgery procedures. Journal of vascular surgery. Venous and lymphatic disorders. 2020. doi:10.1016/j.jvsv.2020.03.017.
- 31.Risk Factors for Delirium after Vascular Surgery: A Systematic Review and Meta-Analysis. Annals of vascular surgery. 2021.PubMed-indexed articleMeta-analysis / systematic review2021
Risk Factors for Delirium after Vascular Surgery: A Systematic Review and Meta-Analysis. Annals of vascular surgery. 2021. doi:10.1016/j.avsg.2021.03.034.
- 32.Diagnosis and Management of Patients With Myocardial Injury After Noncardiac Surgery: A Scientific Statement From the American Heart Association. Circulation. 2021.PubMed-indexed article2021
Diagnosis and Management of Patients With Myocardial Injury After Noncardiac Surgery: A Scientific Statement From the American Heart Association. Circulation. 2021. doi:10.1161/cir.0000000000001024.
- 33.Effect of Regional vs General Anesthesia on Incidence of Postoperative Delirium in Older Patients Undergoing Hip Fracture Surgery: The RAGA Randomized Trial. JAMA. 2022.PubMed-indexed articleRandomized controlled trial2022
Effect of Regional vs General Anesthesia on Incidence of Postoperative Delirium in Older Patients Undergoing Hip Fracture Surgery: The RAGA Randomized Trial. JAMA. 2022. doi:10.1001/jama.2021.22647.
- 34.Patent foramen ovale and perioperative stroke in noncardiac surgery: a systematic review and meta-analysis. British journal of anaesthesia. 2022.PubMed-indexed articleMeta-analysis / systematic review2022
Patent foramen ovale and perioperative stroke in noncardiac surgery: a systematic review and meta-analysis. British journal of anaesthesia. 2022. doi:10.1016/j.bja.2022.06.036.
- 35.Anticoagulation use in perioperative atrial fibrillation after noncardiac surgery: a systematic review and meta-analysis. Swiss medical weekly. 2023.PubMed-indexed articleMeta-analysis / systematic review2023
Anticoagulation use in perioperative atrial fibrillation after noncardiac surgery: a systematic review and meta-analysis. Swiss medical weekly. 2023. doi:10.57187/smw.2023.40056.
- 36.Timing of Postoperative Stroke and Risk of Mortality After Noncardiac Surgery: A Cohort Study. Journal of clinical medicine research. 2023.PubMed-indexed articleRegistry / cohort2023
Timing of Postoperative Stroke and Risk of Mortality After Noncardiac Surgery: A Cohort Study. Journal of clinical medicine research. 2023. doi:10.14740/jocmr4877.
- 37.
- 38.Risk factors and associated outcomes of postoperative delirium after open abdominal aortic aneurysm repair. Journal of vascular surgery. 2024.PubMed-indexed articleRegistry / cohort2024
Risk factors and associated outcomes of postoperative delirium after open abdominal aortic aneurysm repair. Journal of vascular surgery. 2024. doi:10.1016/j.jvs.2023.11.040.
- 39.Preoperative risk prediction models for acute kidney injury after noncardiac surgery: an independent external validation cohort study. British journal of anaesthesia. 2024.PubMed-indexed articleMeta-analysis / systematic review2024
Preoperative risk prediction models for acute kidney injury after noncardiac surgery: an independent external validation cohort study. British journal of anaesthesia. 2024. doi:10.1016/j.bja.2024.02.018.
- 40.European guidelines on peri-operative venous thromboembolism prophylaxis: first update.: Executive summary. European journal of anaesthesiology. 2024.PubMed-indexed articleClinical practice guideline2024
European guidelines on peri-operative venous thromboembolism prophylaxis: first update.: Executive summary. European journal of anaesthesiology. 2024. doi:10.1097/eja.0000000000002025.
- 41.2024 AHA/ACC multisociety guideline for perioperative cardiovascular management for noncardiac surgery. 2024.PubMed-indexed articleClinical practice guideline2024
2024 AHA/ACC multisociety guideline for perioperative cardiovascular management for noncardiac surgery. 2024. doi:10.1161/cir.0000000000001285.
- 42.
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