{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T12:14:57Z","timestamp":1792066497287,"version":"4.4.0"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2021,1,14]],"date-time":"2021-01-14T00:00:00Z","timestamp":1610582400000},"content-version":"vor","delay-in-days":744,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100020276","name":"David Telling Charitable Trust","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100020276","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100006662","name":"National Institute for Health Research (NIHR) Biomedical Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006662","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012141","name":"University Hospitals Bristol NHS Foundation Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012141","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000883","name":"University of Bristol","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000883","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Case series and a post hoc subgroup analysis of a large randomized trial have suggested a potential benefit in treating ruptured abdominal aortic aneurysms (rAAAs) using endovascular aneurysm repair (EVAR) with local anaesthesia (LA) rather than general anaesthesia (GA). The uptake and outcomes of LA in clinical practice remain unknown.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The UK National Vascular Registry was interrogated for patients presenting with rAAA managed with EVAR under different modes of anaesthesia between 1 January 2014 and 31 December 2016. The primary outcome was in-hospital mortality. Secondary outcomes included: the number of centres performing EVAR under LA; the proportion of patients receiving this technique; duration of hospital stay; and postoperative complications.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Some 3101 patients with rAAA were treated in 72 hospitals during the study: 2306 underwent on open procedure and 795 had EVAR (LA, 319; GA, 435; regional anaesthesia, 41). Overall, 56 of 72 hospitals (78 per cent) offered LA for EVAR of rAAA. Baseline characteristics and morphology were similar across the three EVAR subgroups. Patients who had surgery under LA had a lower in-hospital mortality rate than patients who received GA (59 of 319 (18\u00b75 per cent) versus 122 of 435 (28\u00b70 per cent)), and this was unchanged after adjustment for factors known to influence survival (adjusted hazard ratio 0\u00b762, 95 per cent c.i. 0\u00b745 to 0\u00b785; P = 0\u00b7003). Median hospital stay and postoperative morbidity from other complications were similar.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The use of LA for EVAR of rAAA has been adopted widely in the UK. Mortality rates appear lower than in patients undergoing EVAR with GA.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.10973","type":"journal-article","created":{"date-parts":[[2018,8,23]],"date-time":"2018-08-23T09:35:52Z","timestamp":1535016952000},"page":"74-81","source":"Crossref","is-referenced-by-count":37,"title":["Local anaesthesia for endovascular repair of ruptured abdominal aortic aneurysm"],"prefix":"10.1093","volume":"106","author":[{"given":"R","family":"Mouton","sequence":"first","affiliation":[{"name":"Department of Anaesthesia, Southmead Hospital , Bristol,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C A","family":"Rogers","sequence":"additional","affiliation":[{"name":"Clinical Trials and Evaluation Unit, Bristol Medical School, University of Bristol , Bristol,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R A","family":"Harris","sequence":"additional","affiliation":[{"name":"Clinical Trials and Evaluation Unit, Bristol Medical School, University of Bristol , Bristol,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6370-0800","authenticated-orcid":false,"given":"R J","family":"Hinchliffe","sequence":"additional","affiliation":[{"name":"Bristol Surgical Trials Centre, Bristol Medical School, University of Bristol , Bristol,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,1,1]]},"reference":[{"key":"2024092914131787300_bjs10973-bib-0001","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1002\/bjs.6911","article-title":"Propensity scored analysis of outcomes after ruptured abdominal aortic aneurysm","volume":"97","author":"Holt","year":"2010","journal-title":"Br J Surg"},{"key":"2024092914131787300_bjs10973-bib-0002","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1016\/S0140-6736(14)60109-4","article-title":"Mortality from ruptured abdominal aortic aneurysms: clinical lessons from a comparison of outcomes in England and the USA","volume":"383","author":"Karthikesalingam","year":"2014","journal-title":"Lancet"},{"key":"2024092914131787300_bjs10973-bib-0003","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1053\/ejvs.2002.1622","article-title":"Endovascular repair with bifurcated stent-grafts under local anaesthesia to improve outcome of ruptured aortoiliac aneurysms","volume":"23","author":"Lachat","year":"2002","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"2024092914131787300_bjs10973-bib-0004","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1016\/j.ejvs.2006.05.016","article-title":"A randomised trial of endovascular and open surgery for ruptured abdominal aortic aneurysm \u2013 results of a pilot study and lessons learned for future studies","volume":"32","author":"Hinchliffe","year":"2006","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"2024092914131787300_bjs10973-bib-0005","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/j.ejvs.2015.03.028","article-title":"ECAR Investigators. Editor's choice \u2013 ECAR (Endovasculaire ou Chirurgie dans les An\u00e9vrysmes aorto-iliaques Rompus): a French randomized controlled trial of endovascular versus open surgical repair of ruptured aorto-iliac aneurysms","volume":"50","author":"Desgranges","year":"2015","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"2024092914131787300_bjs10973-bib-0006","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1097\/SLA.0b013e31828d4b76","article-title":"Amsterdam Acute Aneurysm Trial Collaborators. Endovascular repair versus open repair of ruptured abdominal aortic aneurysms: a multicenter randomized controlled trial","volume":"258","author":"Reimerink","year":"2013","journal-title":"Ann Surg"},{"key":"2024092914131787300_bjs10973-bib-0007","doi-asserted-by":"crossref","first-page":"2061","DOI":"10.1093\/eurheartj\/ehv125","article-title":"Endovascular strategy or open repair for ruptured abdominal aortic aneurysm: one-year outcomes from the IMPROVE randomized trial","volume":"36","author":"IMPROVE Trial Investigators","year":"2015","journal-title":"Eur Heart J"},{"key":"2024092914131787300_bjs10973-bib-0008","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.1002\/bjs.9852","article-title":"Individual-patient meta-analysis of three randomized trials comparing endovascular versus open repair for ruptured abdominal aortic aneurysm","volume":"102","author":"Sweeting","year":"2015","journal-title":"Br J Surg"},{"key":"2024092914131787300_bjs10973-bib-0009","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1002\/bjs.9410","article-title":"Observations from the IMPROVE trial concerning the clinical care of patients with ruptured abdominal aortic aneurysm","volume":"101","author":"IMPROVE Trial Investigators","year":"2014","journal-title":"Br J Surg"},{"key":"2024092914131787300_bjs10973-bib-0010","volume-title":"Vascular Services Quality Improvement Programme","author":"Vascular Society of Great Britain and Ireland","year":"2017"},{"key":"2024092914131787300_bjs10973-bib-0011","volume-title":"The 21st Century Mortality Files \u2013 Deaths Dataset, England and Wales","author":"Office for National Statistics","year":"2015"},{"key":"2024092914131787300_bjs10973-bib-0012","volume-title":"National Vascular Registry: 2017 Annual Report","author":"Waton","year":"2017"},{"key":"2024092914131787300_bjs10973-bib-0013","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/S0741-5214(05)80042-4","article-title":"Ruptured abdominal aortic aneurysms: who should be offered surgery?","volume":"23","author":"Hardman","year":"1996","journal-title":"J Vasc Surg"},{"key":"2024092914131787300_bjs10973-bib-0014","volume-title":"Multiple Imputation for Nonresponse in Surveys","author":"Rubin","year":"2004"},{"key":"2024092914131787300_bjs10973-bib-0015","doi-asserted-by":"crossref","first-page":"173S","DOI":"10.1016\/j.jvs.2016.03.294","article-title":"Local anesthesia-based endovascular repair of ruptured abdominal aortic aneurysm is associated with lower 30-day mortality in the National Surgical Quality Improvement Program database","volume":"63","author":"El-Hag","year":"2016","journal-title":"J Vasc Surg"},{"key":"2024092914131787300_bjs10973-bib-0016","doi-asserted-by":"crossref","first-page":"147S","DOI":"10.1016\/j.jvs.2016.03.254","article-title":"Decreased mortality with local vs general anesthesia in EVAR for ruptured abdominal aortic aneurysm in the Vascular Quality Initiative database","volume":"63","author":"El-Hag","year":"2016","journal-title":"J Vasc Surg"},{"key":"2024092914131787300_bjs10973-bib-0017","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.jvs.2006.03.039","article-title":"Influence of anesthesia type on outcome after endovascular aortic aneurysm repair: an analysis based on EUROSTAR data","volume":"44","author":"Ruppert","year":"2006","journal-title":"J Vasc Surg"},{"key":"2024092914131787300_bjs10973-bib-0018","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1016\/j.jvs.2005.05.047","article-title":"Local anesthesia for endovascular abdominal aortic aneurysm repair","volume":"42","author":"Verhoeven","year":"2005","journal-title":"J Vasc Surg"},{"key":"2024092914131787300_bjs10973-bib-0019","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1016\/j.ejvs.2011.05.018","article-title":"Local anaesthesia for endovascular repair of infrarenal aortic aneurysms","volume":"42","author":"Geisb\u00fcsch","year":"2011","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"2024092914131787300_bjs10973-bib-0020","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1016\/j.jvs.2011.04.054","article-title":"Results of endovascular aortic aneurysm repair with general, regional, and local\/monitored anesthesia care in the American College of Surgeons National Surgical Quality Improvement Program database","volume":"54","author":"Edwards","year":"2011","journal-title":"J Vasc Surg"},{"key":"2024092914131787300_bjs10973-bib-0021","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1016\/j.jvs.2012.02.047","article-title":"Locoregional anesthesia for endovascular aneurysm repair","volume":"56","author":"Karthikesalingam","year":"2012","journal-title":"J Vasc Surg"},{"key":"2024092914131787300_bjs10973-bib-0022","doi-asserted-by":"crossref","first-page":"1676","DOI":"10.1053\/j.jvca.2016.03.147","article-title":"Modern anesthetic management of ruptured abdominal aortic aneurysms","volume":"30","author":"Hope","year":"2016","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"2024092914131787300_bjs10973-bib-0023","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1111\/anae.14200","article-title":"Definitions of anaesthetic technique and the implications for clinical research","volume":"73","author":"Armstrong","year":"2018","journal-title":"Anaesthesia"},{"key":"2024092914131787300_bjs10973-bib-0024","volume-title":"Continuum of Depth of Sedation: Definition of General Anesthesia and Levels of Sedation\/Analgesia","author":"American Society of Anesthesiologists","year":"2014"}],"container-title":["Journal of British Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fbjs.10973","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/106\/1\/74\/59432721\/bjs10973.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/106\/1\/74\/59432721\/bjs10973.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,29]],"date-time":"2024-09-29T14:13:30Z","timestamp":1727619210000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjs\/article\/106\/1\/74\/6092803"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,1,1]]},"references-count":24,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2019,1,1]]},"published-print":{"date-parts":[[2019,1,1]]}},"URL":"https:\/\/doi.org\/10.1002\/bjs.10973","relation":{},"ISSN":["0007-1323","1365-2168"],"issn-type":[{"value":"0007-1323","type":"print"},{"value":"1365-2168","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2019,1]]},"published":{"date-parts":[[2019,1,1]]}}}