Early discharge strategies after endovascular abdominal aortic repair

We read with great interest the article by Montross et al1Montross B.C. O'Brien-Irr M.S. Koudoumas D. al.The selection of patients for ambulatory endovascular aneurysm repair elective asymptomatic abdominal aortic aneurysm.J Vasc Surg. 2020; 72: 1347-1353Google Scholar entitled “The aneurysm.” Percutaneous strategy is preferred treatment modality in current practice aneurysms low mortality and morbidity.2Greenhalgh R.M. Brown L.C. Powell J.T. Thompson S.G. Epstein Sculpher M.J. Endovascular versus open aneurysm.N Engl J Med. 2010; 362: 1863-1871Google In literature, there are some studies regarding same day discharge (EVAR) patients.3Lachat M.L. Pecoraro F. Mayer Guillet C. Glenck M. Rancic Z. al.Outpatient repair: experience 100 consecutive patients.Ann 2013; 258: 754-758Google However, we would like to mention concerns this study. Patients exposed use iodinated contrast have a higher risk developing acute kidney injury, particularly at 48 72 hours.4Cheng E.L. Hong Q. Yong E. Chandrasekar S. Tan G.W.L. Lo Z.J. Validating contrast-induced nephropathy prediction models repairs.J 71: 1546-1553Google study, serum creatinine values hours were not presented, precluding detection any postprocedural contrast-associated injury. addition, pre-interventional volume replacement therapy recommended during EVAR minimize injury.5Palevsky P.M. Liu K.D. Brophy P.D. Chawla L.S. Parikh C.R. Thakar C.V. al.KDOQI US commentary on 2012 KDIGO clinical guideline injury.Am Kidney Dis. 61: 649-672Google article, it unclear that volume-enhanced was given before or after intervention whether authors considered issue, while recommending early discharge. Finally, guidelines, antiaggregant preoperative prophylactic antibiotic drugs patients.6Wanhainen A. Verzini Van Herzeele I. Allaire Bown Cohnert T. al.Clinical guidelines management aorto-iliac artery aneurysms.Eur Endovasc 2019; 57: 8-93Google no clear data available these medications conclusion, congratulate al their real-setting valuable hear opinions issues.