Rupture of abdominal aortic aneurysms

A concurrent comparison of outcome of those occurring after endoluminal repair versus those occurring de novo

J. May, G. H. White, R. Waugh, X. Chaufour, M. S. Stephen, W. Yu, J. P. Harris

    Research output: Contribution to journalArticle

    44 Citations (Scopus)

    Abstract

    Aim: to compare the outcome of patients whose abdominal aortic aneurysm (AAA) ruptured following endoluminal repair with those whose AAA ruptured prior to treatment. Patients: over a 4-year period 434 patients underwent treatment for AAA with conventional open (n = 253) and endoluminal repair (n = 181). Of those having open repair, 216 patients had elective operations while 41 had operations for ruptured AAA. Four patients with ruptured AAA had undergone endoluminal repair previously (Group I) while the remaining 37 patients ruptured de novo (Group II). The patients in both groups were similar in age and sex but differed clinically. All four patients in Group I had major medical co-morbidities versus 56% in Group II (p < 0.05). All patients in group I had a known endoleak following endoluminal repair. All patients underwent open repair. Results: the proportion of patients presenting with hypotension in Group I (1/4) was significantly less than in Group II (30/37). The difference in 30-day mortality for Group I (0%) compared with that for Group II (43%) was significant. The four patients in Group I remain alive and well at follow-up 22 months after operation. The outcome for Group I was better than Group II despite the higher incidence of medical co-morbidities. Conclusion: endoluminal AAA repair complicated by a persistent endoleak does not protect from rupture, which may not be accompanied by such major haemodynamic changes and high mortality as rupture de novo. Further long-term results in more patients are required to confirm this intermediate level of protection.

    Original languageEnglish
    Pages (from-to)344-348
    Number of pages5
    JournalEuropean Journal of Vascular and Endovascular Surgery
    Volume18
    Issue number4
    DOIs
    Publication statusPublished - Oct 1999

    Keywords

    • Endoluminal repair
    • Endovascular repair
    • Ruptured aortic aneurysm

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