Background: The acute phase of the COVID-19 pandemic requires a redefinition of healthcare system to increase the number of available intensive care units for COVID-19 patients. This leads to the postponement of elective surgeries including the treatment of abdominal aortic aneurysm (AAA). The probabilistic rupture risk index (PRRI) recently showed its advantage over the diameter criterion in AAA rupture risk assessment. Its major improvement is in increased specificity and yet has the same sensitivity as the maximal diameter criterion. The objective of this study was to test the clinical applicability of the PRRI method in a quasi-prospective patient cohort study. Methods: Nineteen patients (fourteen males, five females) with intact AAA who were postponed due to COVID-19 pandemic were included in this study. The PRRI was calculated at the baseline via finite element method models. If a case was diagnosed as high risk (PRRI > 3%), the patient was offered priority in AAA intervention. Cases were followed until 10 September 2021 and a number of false positive and false negative cases were recorded. Results: Each case was assessed within 3 days. Priority in intervention was offered to two patients with high PRRI. There were four false positive cases and no false negative cases classified by PRRI. In three cases, the follow-up was very short to reach any conclusion. Conclusions: Integrating PRRI into clinical workflow is possible. Longitudinal validation of PRRI did not fail and may significantly decrease the false positive rate in AAA treatment.

Introduction: Wound healing complications (WHC) of groin incisions are frequently discussed in vascular surgery. Various preventive measures are often applied to reduce their rates, but not all have the desired effect, and all these measures have their respective costs. The main aim of this study is to determine the effectiveness of closed incision negative pressure therapy (ciNPT) in reducing WHCs in high-risk patients after major revascularization procedures compared to the conventional adhesive dressing and to investigate the cost-benefit of its routine use. Material and methods: From April 2023 to October 2024, 30 patients with 60 groin wounds who underwent aortic-bifemoral bypass surgery had their right groin wound treated with ciNPT and left groin wound with a conventional surgical adhesive dressing. The ciNPT system was removed after 7 days postoperatively. Both wounds were examined on the 7 ^th and 30 ^th postoperative day and any WHCs were marked and graded by the Szilagyi classification. Hospitalization costs and hospital stay periods of all patients were also analyzed. Results: The ciNPT-treated wound showed a statistically significant reduction in WHCs against the conventionally treated contralateral groin ( P = 0.025). None of the ciNPT-treated wounds prolonged hospital stay and a significant increase in hospitalization costs ( P < 0.001) has been observed in patients who developed WHCs, prolonging hospital stay ( P = 0.007). Conclusion: High-risk vascular surgery patients are very likely to benefit from ciNPT and the routine use of this method may also be considered economically, however, additional research must be conducted to evaluate indications better.