Objective: To retrospectively compare a single center’s immediate and mid-term outcomes of ruptured abdominal aorticaneurysm open and endovascular repair (EVAR) for two patient groups—hemodynamically stable and unstablepatients—in the same time period.Methods: Patients presenting at our center with confirmed rupture of an abdominal aortic aneurysm between December1999 and April 2006 were considered according to an intention-to-treat model with EVAR. Patients with symptomaticor acute (but not ruptured) AAAs were not included in this study. Thirty-three patients underwent EVAR, and 91underwent open repair. Seventy-two patients (EVAR, 45%; open, 63%) were classified as hemodynamically unstable atarrival, and 52 were classified as stable (EVAR, 55%; open, 37%). Ninety-seven percent of EVAR procedures commencedunder local anesthesia, and 100% of open repairs occurred with general anesthesia. Overall successful graft deployment,30-day mortality, overall reintervention rate, and complications were the study primary end points.Results: Overall successful graft deployment for EVAR was 91%; for open repair, it was 96%. Overall 30-day mortality forEVAR was 30% (unstable, 53%; stable, 11%), and the rate was 46% for open repair (unstable, 61%; stable, 21%). TheEVAR postoperative reintervention rate (within 30 days) was 15% (unstable, 20%; stable, 11%), and for open repair it was10% (unstable, 9%; stable, 15%). We recorded a 27% severe complication rate for EVAR patients (unstable, 40%; stable,17%), and for patients treated with open repair, it was 33% (unstable, 35%; stable, 29%). Our overall EVAR eligibility ratewas 52%, and our overall EVAR treatment rate was 27%.Conclusions: Our study’s overall results for EVAR remain encouraging when compared with those of conventional repair,but large randomized trials are required to confirm the efficacy of the procedure.
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|Anno di pubblicazione:||2006|
|Titolo:||A single-center experience in open and endovascular treatment of hemodynamically unstable and stable patients with ruptured abdominal aortic aneurysms.|
|Autori:||G. COPPI; R. SILINGARDI; S. GENNAI; G. SAITTA; A.V. CIARDULLO.|
|Appare nelle tipologie:||Articolo su rivista|
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