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Early and Intermediate Outcome of Emergency Endovascular Aneurysm Repair of Ruptured Infrarenal Aortic Aneurysm: A Single-Centre Experience of 90 Consecutive Patients.

Holst, Jan LU ; Resch, Tim LU ; Ivancev, Krassi LU ; Björses, Katarina LU ; Dias, Nuno LU ; Lindblad, Bengt LU ; Mathiessen, S; Sonesson, Björn LU and Malina, Martin LU (2009) In European journal of vascular and endovascular surgery 37. p.413-419
Abstract
OBJECTIVE: To evaluate the early and intermediate outcome of a consecutive series of emergency endovascular aneurysm repairs (eEVAR) of computed tomography (CT)-verified infrarenal ruptured abdominal aortic aneurysm (rAAA) at a single tertiary referral centre. METHODS: Prospectively collected data of patients operated between April 2000 and October 2007 were retrospectively reviewed and all their pre-, intra- and postoperative imaging were re-evaluated. Patient and procedural data were analysed using a Cox multiregression model. RESULTS: Ninety patients (86% men, aged 76 (+/-7) years), were identified and included in the analysis. Symptom duration was <3h in 22% of patients, 3-24h in 39% and >24h in 39%. Mean aneurysmal diameter was... (More)
OBJECTIVE: To evaluate the early and intermediate outcome of a consecutive series of emergency endovascular aneurysm repairs (eEVAR) of computed tomography (CT)-verified infrarenal ruptured abdominal aortic aneurysm (rAAA) at a single tertiary referral centre. METHODS: Prospectively collected data of patients operated between April 2000 and October 2007 were retrospectively reviewed and all their pre-, intra- and postoperative imaging were re-evaluated. Patient and procedural data were analysed using a Cox multiregression model. RESULTS: Ninety patients (86% men, aged 76 (+/-7) years), were identified and included in the analysis. Symptom duration was <3h in 22% of patients, 3-24h in 39% and >24h in 39%. Mean aneurysmal diameter was 73 (+/-14)mm. All patients were treated with the COOK Zenith((R)) stent-graft (56% bi-iliac and 44% uni-iliac). Sixty-one percent were haemodynamically unstable on presentation, and 26% required an intra-operative aortic occlusion balloon to maintain haemodynamic stability. The 30-day and 1-year mortality rates were 27% and 37%, respectively. One-year aneurysm-related mortality was 33%. Twenty-eight percent of patients required re-interventions during the follow-up. The use of an aortic occlusion balloon and the presence of cerebrovascular disease or obstructive lung disorder correlated significantly with 30-day mortality in the multivariate analysis. CONCLUSION: EVAR is a valid treatment option for rAAA when used as a first-line method for all patients. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
European journal of vascular and endovascular surgery
volume
37
pages
413 - 419
publisher
Elsevier
external identifiers
  • WOS:000265199400007
  • PMID:19211279
  • Scopus:61849165081
ISSN
1532-2165
DOI
10.1016/j.ejvs.2008.12.015
language
English
LU publication?
yes
id
dca1b3ab-3f97-4089-8f85-293a10974ca7 (old id 1302660)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19211279?dopt=Abstract
date added to LUP
2009-03-02 14:48:46
date last changed
2017-01-01 07:52:16
@article{dca1b3ab-3f97-4089-8f85-293a10974ca7,
  abstract     = {OBJECTIVE: To evaluate the early and intermediate outcome of a consecutive series of emergency endovascular aneurysm repairs (eEVAR) of computed tomography (CT)-verified infrarenal ruptured abdominal aortic aneurysm (rAAA) at a single tertiary referral centre. METHODS: Prospectively collected data of patients operated between April 2000 and October 2007 were retrospectively reviewed and all their pre-, intra- and postoperative imaging were re-evaluated. Patient and procedural data were analysed using a Cox multiregression model. RESULTS: Ninety patients (86% men, aged 76 (+/-7) years), were identified and included in the analysis. Symptom duration was &lt;3h in 22% of patients, 3-24h in 39% and &gt;24h in 39%. Mean aneurysmal diameter was 73 (+/-14)mm. All patients were treated with the COOK Zenith((R)) stent-graft (56% bi-iliac and 44% uni-iliac). Sixty-one percent were haemodynamically unstable on presentation, and 26% required an intra-operative aortic occlusion balloon to maintain haemodynamic stability. The 30-day and 1-year mortality rates were 27% and 37%, respectively. One-year aneurysm-related mortality was 33%. Twenty-eight percent of patients required re-interventions during the follow-up. The use of an aortic occlusion balloon and the presence of cerebrovascular disease or obstructive lung disorder correlated significantly with 30-day mortality in the multivariate analysis. CONCLUSION: EVAR is a valid treatment option for rAAA when used as a first-line method for all patients.},
  author       = {Holst, Jan and Resch, Tim and Ivancev, Krassi and Björses, Katarina and Dias, Nuno and Lindblad, Bengt and Mathiessen, S and Sonesson, Björn and Malina, Martin},
  issn         = {1532-2165},
  language     = {eng},
  pages        = {413--419},
  publisher    = {Elsevier},
  series       = {European journal of vascular and endovascular surgery },
  title        = {Early and Intermediate Outcome of Emergency Endovascular Aneurysm Repair of Ruptured Infrarenal Aortic Aneurysm: A Single-Centre Experience of 90 Consecutive Patients.},
  url          = {http://dx.doi.org/10.1016/j.ejvs.2008.12.015},
  volume       = {37},
  year         = {2009},
}