Collected World and Single Center Experience With Endovascular Treatment of Ruptured Abdominal Aortic Aneurysms
- 1 November 2009
- journal article
- research article
- Published by Wolters Kluwer Health in Annals of Surgery
- Vol. 250 (5), 818-824
- https://doi.org/10.1097/sla.0b013e3181bdd7f5
Abstract
Case and single center reports have documented the feasibility and suggested the effectiveness of endovascular aneurysm repair (EVAR) of ruptured abdominal aortic aneurysms (RAAAs), but the role and value of such treatment remain controversial. To clarify these we examined a collected experience with use of EVAR for RAAA treatment from 49 centers. Data were obtained by questionnaires from these centers, updated from 13 centers committed to EVAR treatment whenever possible and included treatment details from a single center and information on 1037 patients treated by EVAR and 763 patients treated by open repair (OR). Overall 30-day mortality after EVAR in 1037 patients was 21.2%. Centers performing EVAR for RAAAs whenever possible did so in 28% to 79% (mean 49.1%) of their patients, had a 30-day mortality of 19.7% (range: 0%–32%) for 680 EVAR patients and 36.3% (range: 8%–53%) for 763 OR patients (P < 0.0001). Supraceliac aortic balloon control was obtained in 19.1% ± 12.0% (±SD) of 680 EVAR patients. Abdominal compartment syndrome was treated by some form of decompression in 12.2% ± 8.3% (±SD) of these EVAR patients. These results indicate that EVAR has a lower procedural mortality at 30 days than OR in at least some patients and that EVAR is better than OR for treating RAAA patients provided they have favorable anatomy; adequate skills, facilities, and protocols are available; and optimal strategies, techniques, and adjuncts are employed.Keywords
This publication has 22 references indexed in Scilit:
- A single-center experience in open and endovascular treatment of hemodynamically unstable and stable patients with ruptured abdominal aortic aneurysmsJournal of Vascular Surgery, 2006
- Establishing a protocol for endovascular treatment of ruptured abdominal aortic aneurysms: Outcomes of a prospective analysisJournal of Vascular Surgery, 2006
- Factors associated with abdominal compartment syndrome complicating endovascular repair of ruptured abdominal aortic aneurysmsJournal of Vascular Surgery, 2005
- Midterm outcome of endovascular repair of ruptured abdominal aortic aneurysmsJournal of Vascular Surgery, 2005
- Endovascular Treatment of Acute Abdominal Aortic Aneurysm with a Bifurcated StentgraftEuropean Journal of Vascular and Endovascular Surgery, 2005
- Impact of endovascular repair on early outcomes of ruptured abdominal aortic aneurysmsJournal of Vascular Surgery, 2004
- Endovascular Repair of Ruptured Abdominal Aortic Aneurysms: Logistics and Short-Term ResultsJournal of Endovascular Therapy, 2003
- Endovascular Repair with Bifurcated Stent-Grafts under Local Anaesthesia to Improve Outcome of Ruptured Aortoiliac AneurysmsEuropean Journal of Vascular and Endovascular Surgery, 2002
- Initial Experience with Transluminally Placed Endovascular Grafts for the Treatment of Complex Vascular LesionsAnnals of Surgery, 1995
- Emergency endovascular repair of leaking aortic aneurysmThe Lancet, 1994