Back to Search
Start Over
Endovascular repair of ruptured aneurysms of the infrarenal abdominal aorta: feasibility and results.
- Source :
-
The Journal of cardiovascular surgery [J Cardiovasc Surg (Torino)] 2007 Aug; Vol. 48 (4), pp. 491-5. - Publication Year :
- 2007
-
Abstract
- Aim: Endovascular repair may represent an interesting alternative to open surgery for ruptured abdominal aortic aneurysms (AAA). This study evaluated the feasibility and short-term results of endovascular repair of ruptured AAA at our center.<br />Methods: Between April 2004 and December 2005, all patients admitted to our center for a ruptured AAA were considered for endovascular repair. Patients whose hemodynamic status was too unstable to permit a preoperative CT scan and patients with an unfavorable anatomy for endovascular repair underwent open surgery. Endovascular repair consisted in emergency placement of an aorto-uni-iliac endograft associated with a crossover femoro-femoral bypass and deployment of an occluder in the contralateral common iliac artery. Follow-up postoperative CT scans were obtained 1, 6, 12 and 18 months after intervention and then annually. Data concerning diagnosis, the operative risk, treatment, and follow-up were collated prospectively in a registry and were analyzed on an intention-to-treat basis.<br />Results: Between April 2004 and December 2005, 17 patients were admitted to our Department for a ruptured AAA. Ten patients (59 %) underwent emergency endovascular repair and were included in this study (8 men and 2 women, mean age 81 years, range 51-97). The mean duration of the operation was 167 +/- 37 min. The mean blood transfusion volume was 3 700 +/- 1 400 mL. The mean duration of hospitalization was 19 days (range: 9-60). Mortality at day 30 was 20% (2 patients): one death occurred on day 2 due to multi-organ failure in an 80-year-old patient and another death occurred on day 2 owing to myocardial infarction in an 87-year-old patient. Mean follow-up was 6 months. Late mortality occurred in 2 cases. No endoleaks were observed during follow-up.<br />Conclusion: Our initial results using endografts for the repair of ruptured AAA were satisfactory, with a feasibility of 59% and an operative mortality of 20%. Randomized studies are necessary to determine the true value of endovascular repair of ruptured AAA compared to conventional open repair.
- Subjects :
- Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal diagnostic imaging
Aortic Aneurysm, Abdominal mortality
Aortic Rupture diagnostic imaging
Aortic Rupture mortality
Feasibility Studies
Female
Follow-Up Studies
Humans
Male
Middle Aged
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Angioplasty
Aortic Aneurysm, Abdominal therapy
Aortic Rupture therapy
Blood Vessel Prosthesis Implantation methods
Subjects
Details
- Language :
- English
- ISSN :
- 0021-9509
- Volume :
- 48
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- The Journal of cardiovascular surgery
- Publication Type :
- Academic Journal
- Accession number :
- 17653010