Objective: A retrospective analysis of immediate outcomes following aneurysm rupture (rAAA) in two groups: patientspreviously treated at our center with primary endovascular repair (EVAR) and patients without previous EVAR forabdominal aortic aneurysms (AAA) in an 8-year period.Methods: Fourteen patients with a confirmed rAAA identified throughout the follow-up period following primary EVARrepair at our center (from a population of 820 AAA treated at our center in election) were retrospectively compared with155 patients without previous EVAR in the same time period, from the introduction of an intention-to-treat protocolwith EVAR for rAAA in January 1999. Primary study outcomes included 30-day mortality and severe systemiccomplications following rAAA correction with both open and EVAR treatments.Results: In the 14 patients secondary interventions were necessary throughout follow-up prior to rupture in 43% (6/14).The mean time to rupture was 50.23 months (9-113). The mean increase in maximum aneurysmal diameter at rupturewas 18.39 mm. Type of endoleaks observed at rupture: 35.7% I proximal, 35.7% III contralateral stump disconnection,14.3% I distal, 14.3% III midgraft tear: treatment at rupture included five EVAR corrections with aortouniiliacendografts, four EVAR corrections with extensions, and five surgical conversions. Thirty-day mortality between the twogroups, 28.5% (patients with prior EVAR) 38.7% (patients without prior EVAR), and severe systemic complications, 50%vs 37.6%, were not found to be statistically significant. Hemodynamic instability, 36% (patients with prior EVAR) 63%(patients without prior EVAR), was found to be an independent predictor of 30-day mortality (P < .0001), whereassevere systemic complications, 50% vs 33.5%, did not influence the same outcome (P .852).Conclusions: In terms of mortality, it would be logical to expect a protection from the endograft in patients with previousEVAR. A trend seems to confirm this assumption, but no statistical significance was found, which may be due to the smallpopulation size.

Treatment of ruptured abdominal aortic aneurysm after endovascular abdominal aortic repair: A comparison with patients without prior treatment / Coppi, Gioachino; Gennai, S.; Saitta, G.; Silingardi, R.; Tasselli, S.. - In: JOURNAL OF VASCULAR SURGERY. - ISSN 0741-5214. - ELETTRONICO. - 49:3(2009), pp. 582-588. [10.1016/j.jvs.2008.10.032]

Treatment of ruptured abdominal aortic aneurysm after endovascular abdominal aortic repair: A comparison with patients without prior treatment.

COPPI, Gioachino;S. Gennai;R. Silingardi;
2009

Abstract

Objective: A retrospective analysis of immediate outcomes following aneurysm rupture (rAAA) in two groups: patientspreviously treated at our center with primary endovascular repair (EVAR) and patients without previous EVAR forabdominal aortic aneurysms (AAA) in an 8-year period.Methods: Fourteen patients with a confirmed rAAA identified throughout the follow-up period following primary EVARrepair at our center (from a population of 820 AAA treated at our center in election) were retrospectively compared with155 patients without previous EVAR in the same time period, from the introduction of an intention-to-treat protocolwith EVAR for rAAA in January 1999. Primary study outcomes included 30-day mortality and severe systemiccomplications following rAAA correction with both open and EVAR treatments.Results: In the 14 patients secondary interventions were necessary throughout follow-up prior to rupture in 43% (6/14).The mean time to rupture was 50.23 months (9-113). The mean increase in maximum aneurysmal diameter at rupturewas 18.39 mm. Type of endoleaks observed at rupture: 35.7% I proximal, 35.7% III contralateral stump disconnection,14.3% I distal, 14.3% III midgraft tear: treatment at rupture included five EVAR corrections with aortouniiliacendografts, four EVAR corrections with extensions, and five surgical conversions. Thirty-day mortality between the twogroups, 28.5% (patients with prior EVAR) 38.7% (patients without prior EVAR), and severe systemic complications, 50%vs 37.6%, were not found to be statistically significant. Hemodynamic instability, 36% (patients with prior EVAR) 63%(patients without prior EVAR), was found to be an independent predictor of 30-day mortality (P < .0001), whereassevere systemic complications, 50% vs 33.5%, did not influence the same outcome (P .852).Conclusions: In terms of mortality, it would be logical to expect a protection from the endograft in patients with previousEVAR. A trend seems to confirm this assumption, but no statistical significance was found, which may be due to the smallpopulation size.
2009
49
3
582
588
Treatment of ruptured abdominal aortic aneurysm after endovascular abdominal aortic repair: A comparison with patients without prior treatment / Coppi, Gioachino; Gennai, S.; Saitta, G.; Silingardi, R.; Tasselli, S.. - In: JOURNAL OF VASCULAR SURGERY. - ISSN 0741-5214. - ELETTRONICO. - 49:3(2009), pp. 582-588. [10.1016/j.jvs.2008.10.032]
Coppi, Gioachino; Gennai, S.; Saitta, G.; Silingardi, R.; Tasselli, S.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/644733
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