Effects of Preoperative Low-dose Aspirin on the Incidence of Mesenteric Traction Syndrome in Open Abdominal Aortic Aneurysm Repair: A Retrospective Cohort Study.

Abstract

Objective: The effect of preoperative low-dose aspirin on the incidence of mesenteric traction syndrome (MTS) remains unclear. This study was designed to investigate the effect of preoperative low-dose aspirin in patients undergoing open abdominal aortic aneurysm repair.

Design: Single-center, retrospective cohort study.

Setting: Academic medical center.

Participants: A total of 147 patients undergoing open abdominal aortic aneurysm repair for unruptured abdominal aortic aneurysm between July 2016 and December 2022 were recruited. Patients with infectious abdominal aortic aneurysm and those undergoing simultaneous repair of thoracic aortic aneurysm were excluded.

Intervention: Overall, 114 patients who met the inclusion criteria were divided into two groups. The aspirin group received preoperative low-dose aspirin (81-100 mg daily) as antiplatelet therapy for the primary and secondary prevention of cardiovascular events and stroke (n = 35), and the nonaspirin group received no aspirin (n = 79).

Measurements and main results: The incidence of intraoperative MTS was lower in the aspirin group than in the nonaspirin group (17% v 41%). Twenty-six patients in the aspirin group discontinued daily aspirin within 7 days before surgery, and only one (4%) developed MTS. In contrast, five of nine patients (56%) who discontinued aspirin 8 days or more before surgery developed MTS. After adjusting for confounders, logistic regression analysis revealed that preoperative low-dose aspirin was associated with a lower incidence of MTS (odds ratio: 0.300, 95% confidence interval: 0.102-0.777, p = 0.012).

Conclusions: Preoperative low-dose aspirin reduced the risk of MTS in patients undergoing open abdominal aortic aneurysm repair.