Outcomes after open repair for ruptured abdominal aortic aneurysms in patients with friendly versus hostile aortoiliac anatomy.
Eur J Vasc Endovasc Surg
; 47(4): 380-7, 2014 Apr.
Article
en En
| MEDLINE
| ID: mdl-24485844
ABSTRACT
OBJECTIVES:
In patients with a ruptured abdominal aortic aneurysm (RAAA), anatomic suitability for endovascular aneurysm repair (EVAR) depends on aortic neck and iliac artery characteristics. If the aortoiliac anatomy is unsuitable for EVAR ("hostile anatomy"), open repair (OR) is the next option. We hypothesized that the death rate for OR is higher in patients with hostile anatomy than in patients with friendly anatomy.METHODS:
We conducted an observational cohort study in 279 consecutive patients with an RAAA treated with OR between 2004 and 2011. The primary endpoint was 30-day or in-hospital death. Aortoiliac anatomy (friendly vs. hostile) was determined prospectively by the vascular surgeon and the interventional radiologist treating the patient. A multivariable logistic regression analysis was done to assess the risk of dying in patients with hostile anatomy after adjustment for age, sex, comorbidity, and hemodynamic stability.RESULTS:
Aortoiliac anatomy was friendly in 71 patients and hostile in 208 patients. Death rate was 38% (95% confidence interval (CI) 28 to 50%) in patients with friendly anatomy and 30% (95% CI 24 to 37%) in patients with hostile anatomy (p = .23). After multivariable adjustment, the risk of dying was not higher in patients with hostile anatomy (adjusted odds ratio 0.744, 95% CI 0.394 to 1.404).CONCLUSION:
The death rate after open repair for an RAAA is comparable in patients with friendly and hostile aortoiliac anatomy.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Rotura de la Aorta
/
Aneurisma de la Aorta Abdominal
Tipo de estudio:
Etiology_studies
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Incidence_studies
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Observational_studies
/
Risk_factors_studies
Límite:
Aged
/
Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Eur J Vasc Endovasc Surg
Asunto de la revista:
ANGIOLOGIA
Año:
2014
Tipo del documento:
Article
País de afiliación:
Países Bajos