Title:Perioperative/Periprocedural Effects of Statin Treatment for Patients Undergoing Vascular Surgery or Endovascular Procedures: An Update
Volume: 11
Issue: 1
Author(s): Kosmas I. Paraskevas, Frank J. Veith, Christos D. Liapis and Dimitri P. Mikhailidis
Affiliation:
Keywords:
Statins, vascular surgery, endovascular procedures, pleiotropic effects, postoperative complications, perioperative
effects
Abstract: Introduction/Aim: We reviewed the literature for studies evaluating the effects of statins on vascular patients
undergoing open surgical or endovascular procedures.
Methods: MEDLINE was searched using the search terms “statins and vascular surgery”, “statins and endovascular procedures”,
“statins and perioperative effects” and “statins and postoperative complications”.
Results: Preoperative statin use is associated with lower perioperative/periprocedural death, myocardial infarction and
stroke rates. Statins may also reduce postoperative complications as well as hospitalization rates and costs. Statins reduce
the incidence of postoperative/postprocedural renal insufficiency and help the earlier recovery of complete kidney function
in vascular patients. A loading dose of statins prior to a procedure may be associated with improved cardiovascular
outcomes.
Conclusions: Statins are associated with several beneficial actions in patients undergoing open surgical or endovascular
procedures. Nevertheless, statin use in vascular patients still remains underutilized and suboptimal. Ideally, statins should
be initiated a minimum of 2 weeks before the procedure. Extended-release formulas may be preferable perioperatively to
cover the first 1-2 days after the procedure when oral intake may not be feasible. Statins should be administered to all vascular
disease patients, whether they are managed conservatively or are undergoing open surgical or endovascular procedures.
