Collected World and Single Center Experience With Endovascular Treatment of Ruptured Abdominal Aortic Aneurysms.

Research output: Contribution to journalArticle

Abstract

BACKGROUND:: 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. OBJECTIVE:: To clarify these we examined a collected experience with use of EVAR for RAAA treatment from 49 centers. METHODS:: 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). RESULTS:: 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. CONCLUSION:: 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.

Details

Authors
  • Frank Veith
  • Mario Lachat
  • Dieter Mayer
  • Martin Malina
  • Manish Mehta
  • Eric Verhoeven
  • Thomas Larzon
  • Stefano Gennai
  • Gioacchino Coppi
  • Evan Lipsitz
  • Nicholas Gargiulo
  • J van der Vliet
  • Jan Blankensteijn
  • Jacob Buth
  • W Lee
  • Giorgio Biasi
  • Gaetano Deleo
  • Karthikeshwar Kasirajan
  • Randy Moore
  • Chee Soong
  • Neal Cayne
  • Mark Farber
  • Dieter Raithel
  • Roy Greenberg
  • Marc van Sambeek
  • Jan Brunkwall
  • Caron Rockman
  • Robert Hinchliffe
Organisations
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Surgery
Original languageEnglish
Pages (from-to)818-824
JournalAnnals of Surgery
Volume250
Issue number5
Early online date2009 Oct 5
Publication statusPublished - 2009
Publication categoryResearch
Peer-reviewedYes

Bibliographic note

The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Emergency medicine/Medicine/Surgery (013240200)