Endovascular repair of ruptured abdominal aortic aneurysm - A challenge to open repair? Results of a single centre experience in 20 patients

被引:104
作者
Hinchliffe, RJ [1 ]
Yusuf, SW [1 ]
Macierewicz, JA [1 ]
MacSweeney, STR [1 ]
Wenham, PW [1 ]
Hopkinson, BR [1 ]
机构
[1] Univ Nottingham Hosp, Dept Vasc & Endovasc Surg, Nottingham NG7 2UH, England
关键词
ruptured abdominal aortic aneurysm; endovascular repair;
D O I
10.1053/ejvs.2001.1513
中图分类号
R61 [外科手术学];
学科分类号
摘要
Introduction: the mortality from ruptured abdominal aortic aneurysm (AAA) remains in the region of 50% despite advances in critical care. Endovascular repair of AAA has been shown to be associated with reduced physiological stress in the elective setting. It is hypothesised that the reduced physiological stress associated with EVAR may improve, the outcome in patients with ruptured AAA. Methods. a feasibility, study of endovascular repair of ruptured AAA was undertaken at the University Hospital, Nottingham, U.K. between 1994 and 2000. Patients admitted with ruptured AAA were assessed by a team familiar with endovascular techniques for elective repair of AAA. After giving informed consent patients underwent spiral computed tomographic cases. Patients were then transferred to the operating theatre for graphic angiography (CTA), in the majority of EVAR. Results: twenty patients underwent repair of ruptured AAA. Of these 20 patients, seven were referred from another hospital. Eight patients were considered unfit for open repair. The median duration of procedure was 180 min (range 120-480) and median blood loss was 1200, ml (range 750-2000 ml). The overall peri-operative mortality was 45%. A number of intra-operative and peri-operative, procedures (both open and endovascular) were required to ensure aneurysm exclusion and to deal with the complications of endovascular surgery. Conclusions: ruptured AAA remains a particularly hazardous condition to treat. There are a number of advantages of EVAR in this condition. A number of the problems early in the experience of EVAR have been addressed, but further experience is required to demonstrate its efficacy when compared with open repair.
引用
收藏
页码:528 / 534
页数:7
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