scholarly journals Mortality After Elective and Ruptured Abdominal Aortic Aneurysm Surgical Repair: 12-Year Single-Center Experience of Estonia

2017 ◽  
Vol 107 (2) ◽  
pp. 152-157 ◽  
Author(s):  
J. Lieberg ◽  
L.-L. Pruks ◽  
M. Kals ◽  
K. Paapstel ◽  
A. Aavik ◽  
...  
Keyword(s):  
Risk Factors ◽  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Open Repair ◽  
Mortality Rates ◽  
Ruptured Abdominal Aortic Aneurysm ◽  
Abdominal Aortic ◽  
All Cause Mortality ◽  
Aneurysm Repair ◽  
Elective Abdominal Aortic Aneurysm

Background and Aims: Abdominal aortic aneurysm is a degenerative vascular pathology with high mortality due to its rupture, which is why timely treatment is crucial. The current single-center retrospective study was undertaken to analyze short- and long-term all-cause mortality after operative treatment of abdominal aortic aneurysm and to examine the factors that influence outcome. Material and Methods: The data of all abdominal aortic aneurysm patients treated with open repair or endovascular aneurysm repair in 2004–2015 were retrospectively retrieved from the clinical database of Tartu University Hospital. The primary endpoint was 30-day, 90-day, and 5-year all-cause mortality. The secondary endpoint was determination of the risk factors for mortality. Results and Conclusion: Elective abdominal aortic aneurysm repair was performed on 228 patients (mean age 71.8 years), of whom 178 (78%) were treated with open repair and 50 (22%) with endovascular aneurysm repair. A total of 48 patients with ruptured abdominal aortic aneurysm were treated with open repair (mean age 73.8 years) at the Department of Vascular Surgery, Tartu University Hospital, Estonia. Mean follow-up period was 4.2 ± 3.3 years. In patients with elective abdominal aortic aneurysm, 30-day, 90-day, and 5-year all-cause mortality rates were 0.9%, 2.6%, and 32%, respectively. In multivariate analysis, the main predictors for 5-year mortality were preoperative creatinine value and age (p < 0.05). In patients with ruptured abdominal aortic aneurysm, 30-day, 90-day, and 5-year all-cause mortality rates were 22.9%, 33.3%, and 55.1%, respectively. In multivariate analysis, the risk factors for 30-day mortality in ruptured abdominal aortic aneurysm were perioperative hemoglobin and lactate levels (p < 0.05). According to this study, the all-cause mortality rates of elective abdominal aortic aneurysm and ruptured abdominal aortic aneurysm at our hospital were comparable to those at other centers worldwide. Even though some variables were identified as potential predictors of survival, the mortality rates after ruptured abdominal aortic aneurysm remain high. Early diagnosis, timely treatment, and detection of the risk factors for abdominal aortic aneurysm progression would improve survival in patients with abdominal aortic aneurysm.

scholarly journals SS21. Mortality Rates of Ruptured Abdominal Aortic Aneurysm Repair Have Not Changed With Increasing Utilization of EVAR

2016 ◽  
Vol 63 (6) ◽  
pp. 139S-140S ◽  
Author(s):  
Christopher B. Washington ◽  
Elizabeth A. Genovese ◽  
Michael J. Singh ◽  
Rabih A. Chaer ◽  
Michel S. Makaroun ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Mortality Rates ◽  
Abdominal Aortic Aneurysm Repair ◽  
Ruptured Abdominal Aortic Aneurysm ◽  
Abdominal Aortic ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair

Endovascular Aneurysm Repair and Outcomes in Patients Unfit for Open Repair of Abdominal Aortic Aneurysm

2017 ◽  
Author(s):  
Lloyd M. Jones ◽  
Wayne W. Zhang ◽  
SreyRam Kuy ◽  
Tze-Woei Tan
Keyword(s):  
Quality Of Life ◽  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Statistical Difference ◽  
Open Repair ◽  
Abdominal Aortic ◽  
All Cause Mortality ◽  
Aneurysm Repair ◽  
Related Mortality

This randomized controlled trial, the endovascular aortic aneurysm repair (EVAR) trial 2, compared outcomes of EVAR and medical management of abdominal aortic aneurysm in patients who were deemed high risk and unfit for open repair. Three hundred thirty-eight patients were enrolled and randomized to undergo either EVAR or medical therapy alone. Endpoints were all-cause mortality, aneurysm-related mortality, quality of life, postoperative complications, and hospital costs. Although there was some cross-over between groups and this has been cited as a limitation of this study, there was no statistical difference in all-cause mortality between the two groups. With longer follow-up (median 3.1 years), there was a reduction in aneurysm-related mortality with endovascular repairs. There was no statistical difference in health-related quality of life; however, there was a higher cost associated with EVAR.

Improved results in the management of ruptured abdominal aortic aneurysm may not be on the basis of endovascular aneurysm repair alone

Vascular ◽  
2013 ◽  
Vol 22 (1) ◽  
pp. 51-54 ◽  
Author(s):  
Dipankar Mukherjee ◽  
Elias Kfoury ◽  
Keilla Schmidt ◽  
Tarek Waked ◽  
Homayoun Hashemi
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Open Repair ◽  
Endovascular Aneurysm Repair ◽  
Ruptured Abdominal Aortic Aneurysm ◽  
Abdominal Aortic ◽  
Clinical Series ◽  
Hybrid Repair ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair

Recent improvement in the survival of patients presenting with a ruptured abdominal aortic aneurysm (rAAA) has been credited to endovascular aneurysm repair (EVAR). We present our clinical series in the management of rAAA from 2007 to 2011. A total of 55 consecutive patient charts were reviewed. Thirty-eight patients underwent EVAR, 17 of the 55 patients did not have favorable anatomy for EVAR. Nine of the 17 patients underwent standard open repair. Eight patients underwent a ‘hybrid repair’ defined as suprarenal aortic endovascular balloon control followed by open repair. Overall 30-day mortality for all 55 patients was 22%. Mortality for the patients managed by endovascular aortic aneurysm repair was 26% compared with 22% with open repair. There were no deaths in the eight patients undergoing the hybrid repair. Endovascular balloon control of the aorta followed by open rAAA repair in patients who are not candidates for rEVAR has produced good results in our experience. Improved results being reported in the management of rAAA may not be on the basis of endovascular repair alone.

Role of the Hardman Index in Predicting Mortality for Open and Endovascular Repair of Ruptured Abdominal Aortic Aneurysm

2007 ◽  
Vol 14 (4) ◽  
pp. 528-535 ◽  
Author(s):  
Muhammad Anees Sharif ◽  
Bernard Lee ◽  
Ragai Reda Makar ◽  
William Loan ◽  
Chee Voon Soong
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Endovascular Repair ◽  
Open Repair ◽  
Prognostic Index ◽  
Mortality Rates ◽  
Loss Of Consciousness ◽  
Ruptured Abdominal Aortic Aneurysm ◽  
Chi Square ◽  
Abdominal Aortic

Purpose: To correlate the Hardman prognostic index with perioperative mortality in patients undergoing open and endovascular repair of ruptured abdominal aortic aneurysm (rAAA). Methods: Over a 5-year period, 126 patients (109 men; mean age 74 years, range 51–91) underwent open (n=74) or endovascular (n=52) repair of rAAA in a single unit. Five Hardman factors (age >76 years, history of loss of consciousness, ECG evidence of ischemia, hemoglobin <9.0 g/dL, and serum creatinine >0.19 mmol/L) were assessed, and their association with in-hospital or 30-day mortality was evaluated retrospectively by chi-square or logistic regression analysis. Results: The mortality for open repair was 51.4% (38/74) in comparison to 32.7% (17/52) for the endovascular group (p=0.05). On multivariate analysis, loss of consciousness (p=0.03, OR 2.9, 95% CI 1.1 to 7.5) was the only significant predictor of mortality in both groups. The mortality rates for open repair patients with Hardman scores <2 were 43.5% (20/46) in comparison to 22.9% (8/35) for the endovascular group (p=0.06), whereas mortality rates for patients with scores ≥2 were 64.3% (18/28) and 52.9% (9/17) for the respective groups (p=0.54). Conclusion: The Hardman index correlates well with mortality in both the open and endovascular groups. Those with a score <2 have a trend toward better survival following endovascular repair compared to open repair, while this benefit is not obvious in patients with a score ≥2.

Sign in / Sign up

Export Citation Format

Share Document