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Pathophysiology and management of compartment syndromes in vascular surgery 

Pathophysiology and management of compartment syndromes in vascular surgery
Chapter:
Pathophysiology and management of compartment syndromes in vascular surgery
Author(s):

Mark Hamilton

, Prue Cowled

, and Robert Fitridge

DOI:
10.1093/med/9780199658220.003.0009
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date: 18 September 2019

Compartment syndrome is defined as a pathological condition where the pressures within a compartment are elevated to the point where tissue ischaemia and/or necrosis ensue. It is most commonly encountered in the lower limbs, but abdominal compartment syndrome is a significant problem following ruptured abdominal aortic aneurysm. Limb compartment syndromes are a relatively common consequence of ischaemia-reperfusion syndrome in vascular surgery. The approaches to managing compartment syndrome in the limbs are well defined, the key points being early and regular assessment with a high index of suspicion, and early decompression of all affected compartments when present. Abdominal compartment syndrome is an evolving area of practice, which is now recognized as a significant cause of post-operative morbidity and mortality in patients with rAAA, particularly those in the new era of endovascular repair of rAAA. New strategies in managing IRI with pre- and post-conditioning show some promise of amelioration of the IRI insult, reducing the consequences of ischaemia.

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