scholarly journals Open Repair of Ruptured Abdominal Aortic Aneurysm: The Suitability of Endovascular Aneurysm Repair Does Not Influence Operative Mortality

2015 ◽  
Vol 31 (3) ◽  
pp. 81-86 ◽  
Author(s):  
Hye Young Yoon ◽  
Jayun Cho ◽  
Incheol Song ◽  
Hyung-Kee Kim ◽  
Seung Huh
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Operative Mortality ◽  
Open Repair ◽  
Endovascular Aneurysm Repair ◽  
Ruptured Abdominal Aortic Aneurysm ◽  
Abdominal Aortic ◽  
Aneurysm Repair

Elective endovascular vs. open repair for abdominal aortic aneurysm in octogenarians

Vascular ◽  
2016 ◽  
Vol 24 (4) ◽  
pp. 348-354 ◽  
Author(s):  
Koichi Morisaki ◽  
Takuya Matsumoto ◽  
Yutaka Matsubara ◽  
Kentaro Inoue ◽  
Yukihiko Aoyagi ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Operative Mortality ◽  
Open Repair ◽  
Endovascular Aneurysm Repair ◽  
Aortic Aneurysms ◽  
Abdominal Aortic ◽  
Elective Repair ◽  
Aneurysm Repair ◽  
Repair Group

Purpose The purpose of this study was to investigate the operative mortality and short-term and midterm outcomes of treatment of abdominal aortic aneurysm in Japanese patients over 80 years of age. Methods Between January 2007 and December 2011, 207 patients underwent elective repair of infrarenal abdominal aortic aneurysms. Comorbidities, operative morbidity and mortality, midterm outcomes were analyzed retrospectively. Results The average age (endovascular aneurysm repair, 84.4 ± 0.3; open, 82.8 ± 0.3, P < 0.01) and the percentage of hostile abdomen (endovascular aneurysm repair, 22.2%; open repair, 11.1%, P < 0.05) were higher in the endovascular aneurysm repair group. Percentage of outside IFU was higher in open repair (endovascular aneurysm repair, 38.5%; open repair, 63.3%, P < 0.01). The cardiac complication (endovascular aneurysm repair, 0%; open repair, 5.6%, P < 0.01) and length of postoperative hospital stay (endovascular aneurysm repair, 10.3 ± 0.8 days; open, 18.6 ± 1.6 days, P < 0.05) were significantly lower in the endovascular aneurysm repair group. There were no differences in operative mortality (endovascular aneurysm repair, 0%; open, 1.1%, P = 0.43) and the aneurysm-related death was not observed. The rate of secondary interventions (EVAR, 5.1%; open repair, 0%, P < 0.01) and midterm mortality rate were much higher in the endovascular aneurysm repair group. Conclusions Endovascular aneurysm repair is less invasive than open repair and useful for treating abdominal aortic aneurysm in octogenarians; however, open repair can be acceptable treatment in the inappropriate case treated by endovascular aneurysm repair.

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.

scholarly journals Treatment of Ruptured Abdominal Aortic Aneurysms: State of the Art

2018 ◽  
Vol 31 (4) ◽  
pp. 213 ◽  
Author(s):  
José Oliveira-Pinto ◽  
Joel Sousa ◽  
Armando Mansilha
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Observational Studies ◽  
Open Repair ◽  
Endovascular Aneurysm Repair ◽  
Ruptured Abdominal Aortic Aneurysm ◽  
Randomized Controlled ◽  
Abdominal Aortic ◽  
Operative Complications ◽  
Aneurysm Repair

Introduction: Endovascular aneurysm repair for ruptured abdominal aortic aneurysm has been increasingly advocated due to short term benefits. Most observational studies point towards survival advantage for endovascular aneurysm repair over open repair. However, randomized clinical trials already performed did not support this data. The aim of this review is to compare post-operative outcomes between endovascular aneurysm repair and open surgery for the treatment of ruptured abdominal aortic aneurysms.Materials and Methods: MEDLINE databases were searched to access outcomes after endovascular aneurysm repair for ruptured abdominal aortic aneurysm and open repair for ruptured abdominal aneurysm repair. All the randomized controlled trials were included. Large and contemporary observational studies were also considered.Results: Thirty day mortality ranged between 18% - 53% for endovascular aneurysm repair for ruptured abdominal aortic aneurysm and between 24% - 53% for open repair. Post-operative complications ranged between 33% - 77% for endovascular aneurysm repair for ruptured abdominal aortic aneurysm and 37% - 80% for open repair. In hospital stay ranged between 8.5 and 14.3 days for endovascular aneurysm repair for ruptured abdominal aortic aneurysm and between 12.2 and 20.5 days for open repair. Intensive care unit days ranged between 1.75 - 4.2 days for endovascular aneurysm repair for ruptured abdominal aortic aneurysm and 2.5 - 6.3 days for open repair.Discussion: Survival benefit is found for endovascular aneurysm repair for ruptured abdominal aortic aneurysm in most observational studies, but those are not reproduced by randomized controlled trials data. However, endovascular aneurysm repair for ruptured abdominal aortic aneurysm showed less post-operative complications and hospitalization days.Conclusion: Endovascular aneurysm repair for ruptured abdominal aortic aneurysm should be considered as first line of treatment in centers with expertise and proper facilities.

scholarly journals Aortocaval fistula, a potentially favourable complication of abdominal aortic aneurysm rupture in endovascular repair

2020 ◽  
Vol 102 (8) ◽  
pp. e180-e182 ◽  
Author(s):  
S Greenfield ◽  
G Martin ◽  
M Malina ◽  
NS Theivacumar
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Endovascular Aneurysm Repair ◽  
Unexpected Finding ◽  
Ruptured Abdominal Aortic Aneurysm ◽  
Aortocaval Fistula ◽  
Abdominal Aortic ◽  
Type 2 Endoleak ◽  
Aneurysm Repair

Endovascular aneurysm repair is an established treatment for ruptured abdominal aortic aneurysm. Primary aortocaval fistula is an exceedingly rare finding in ruptured abdominal aortic aneurysm, with a reported incidence of less than 1%. The presence of an aortocaval fistula used to be an unexpected finding in open surgical repair which often resulted in massive haemorrhage and caval injury. We present a case of ruptured abdominal aortic aneurysm with an aortocaval fistula that was successfully treated with percutaneous endovascular aneurysm repair under local anaesthesia. Despite a persistent type 2 endoleak the aneurysm sack shrank from 8.4cm to 4.8cm in 12 months. The presence of an aortocaval fistula may have depressurised the aneurysm, resulting in less bleeding retroperitoneally and may have promoted rapid shrinkage of the sac despite the presence of a persistent type 2 endoleak.

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