Perioperative/Periprocedural Effects of Statin Treatment for Patients Undergoing Vascular Surgery or Endovascular Procedures: An Update

Kosmas      I. Paraskevas; Frank      J. Veith; Christos      D. Liapis; Dimitri      P. Mikhailidis

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.

Keywords: Statins, vascular surgery, endovascular procedures, pleiotropic effects, postoperative complications, perioperative effects

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