Emergency endovascular aneurysm repair for ruptured abdominal aortic aneurysms: an institutional experience.
Acta Chir Belg
; 110(3): 272-4, 2010.
Article
em En
| MEDLINE
| ID: mdl-20690506
ABSTRACT
OBJECTIVES:
Emergency endovascular aneurysm repair (eEVAR) for ruptured abdominal aortic aneurysms (rAAA) is still under investigation. Since installation of an urgent eEVAR kit in our hospital, all patients with a rAAA or urgent thoracic aortic aneurysm are candidates for eEVAR or eTEVAR (emergency thoracic EVAR), respectively. For this study, we analyzed all rAAA patients treated with eEVAR.METHODS:
Data were recorded prospectively. Criteria for an eEVAR were an infrarenal neck > or = 15 mm, acceptable landing zone, angles below 70 degrees and a good femoral approach. We prefer preoperative angio CT-scan but in case of instability, an intra-aortic balloon can stabilize the patient during angiography (in the OR) to decide between open or eEVAR repair. Follow-up was performed on regular intervals by duplex or CT-scan. Thirty-day mortality and overall survival were calculated.RESULTS:
Since 2006, nine male rAAA patients with a mean age of 73 years (range 62-82) had eEVAR repair. Aneurysm diameter was 8 cm (range 5.8-11). The Hardman index was 1.5 (range 0-3). In eight patients an aorto-uni-iliac device was placed succesfully followed by a femorofemoral crossover bypass. The 30-day operative mortality was 12.5% (one patient with septic shock). Three patients showed a type 2 endoleak with stable diameter during follow-up but one patient showed expansion 4 years after treatment.CONCLUSIONS:
Treating rAAA with eEVAR in selected patients with acceptable anatomy and a kit permanently available in the operating room yielded good results by a surgical team trained for both open and eEVAR repair. The conversion rate was low (11%) and the survival (immediate and 30-days) was excellent (87.5%).
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Aneurisma da Aorta Abdominal
/
Implante de Prótese Vascular
/
Emergências
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
Limite:
Aged
/
Aged80
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Acta Chir Belg
Ano de publicação:
2010
Tipo de documento:
Article
País de afiliação:
Bélgica