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Collected World and Single Center Experience With Endovascular Treatment of Ruptured Abdominal Aortic Aneurysms.

Veith, Frank; Lachat, Mario; Mayer, Dieter; Malina, Martin LU ; Holst, Jan LU ; Mehta, Manish; Verhoeven, Eric; Larzon, Thomas; Gennai, Stefano and Coppi, Gioacchino, et al. (2009) In Annals of Surgery
Abstract
BACKGROUND:: Case and single center reports have documented the feasibility and suggested the effectiveness of endovascular aneurysm repair (EVAR) of ruptured abdominal aortic aneurysms (RAAAs), but the role and value of such treatment remain controversial. OBJECTIVE:: To clarify these we examined a collected experience with use of EVAR for RAAA treatment from 49 centers. METHODS:: Data were obtained by questionnaires from these centers, updated from 13 centers committed to EVAR treatment whenever possible and included treatment details from a single center and information on 1037 patients treated by EVAR and 763 patients treated by open repair (OR). RESULTS:: Overall 30-day mortality after EVAR in 1037 patients was 21.2%. Centers... (More)
BACKGROUND:: Case and single center reports have documented the feasibility and suggested the effectiveness of endovascular aneurysm repair (EVAR) of ruptured abdominal aortic aneurysms (RAAAs), but the role and value of such treatment remain controversial. OBJECTIVE:: To clarify these we examined a collected experience with use of EVAR for RAAA treatment from 49 centers. METHODS:: Data were obtained by questionnaires from these centers, updated from 13 centers committed to EVAR treatment whenever possible and included treatment details from a single center and information on 1037 patients treated by EVAR and 763 patients treated by open repair (OR). RESULTS:: Overall 30-day mortality after EVAR in 1037 patients was 21.2%. Centers performing EVAR for RAAAs whenever possible did so in 28% to 79% (mean 49.1%) of their patients, had a 30-day mortality of 19.7% (range: 0%-32%) for 680 EVAR patients and 36.3% (range: 8%-53%) for 763 OR patients (P < 0.0001). Supraceliac aortic balloon control was obtained in 19.1% +/- 12.0% (+/-SD) of 680 EVAR patients. Abdominal compartment syndrome was treated by some form of decompression in 12.2% +/- 8.3% (+/-SD) of these EVAR patients. CONCLUSION:: These results indicate that EVAR has a lower procedural mortality at 30 days than OR in at least some patients and that EVAR is better than OR for treating RAAA patients provided they have favorable anatomy; adequate skills, facilities, and protocols are available; and optimal strategies, techniques, and adjuncts are employed. (Less)
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Annals of Surgery
publisher
Lippincott Williams & Wilkins
external identifiers
  • pmid:19809296
  • wos:000208667400021
  • scopus:70449337448
ISSN
1528-1140
DOI
10.1097/SLA.0b013e3181bdd7f5
language
English
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yes
id
e12e8e95-fb2b-4fe4-9014-a802e949b1c2 (old id 1500549)
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http://www.ncbi.nlm.nih.gov/pubmed/19809296?dopt=Abstract
date added to LUP
2009-11-04 10:04:44
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2017-12-17 04:02:35
@article{e12e8e95-fb2b-4fe4-9014-a802e949b1c2,
  abstract     = {BACKGROUND:: Case and single center reports have documented the feasibility and suggested the effectiveness of endovascular aneurysm repair (EVAR) of ruptured abdominal aortic aneurysms (RAAAs), but the role and value of such treatment remain controversial. OBJECTIVE:: To clarify these we examined a collected experience with use of EVAR for RAAA treatment from 49 centers. METHODS:: Data were obtained by questionnaires from these centers, updated from 13 centers committed to EVAR treatment whenever possible and included treatment details from a single center and information on 1037 patients treated by EVAR and 763 patients treated by open repair (OR). RESULTS:: Overall 30-day mortality after EVAR in 1037 patients was 21.2%. Centers performing EVAR for RAAAs whenever possible did so in 28% to 79% (mean 49.1%) of their patients, had a 30-day mortality of 19.7% (range: 0%-32%) for 680 EVAR patients and 36.3% (range: 8%-53%) for 763 OR patients (P &lt; 0.0001). Supraceliac aortic balloon control was obtained in 19.1% +/- 12.0% (+/-SD) of 680 EVAR patients. Abdominal compartment syndrome was treated by some form of decompression in 12.2% +/- 8.3% (+/-SD) of these EVAR patients. CONCLUSION:: These results indicate that EVAR has a lower procedural mortality at 30 days than OR in at least some patients and that EVAR is better than OR for treating RAAA patients provided they have favorable anatomy; adequate skills, facilities, and protocols are available; and optimal strategies, techniques, and adjuncts are employed.},
  author       = {Veith, Frank and Lachat, Mario and Mayer, Dieter and Malina, Martin and Holst, Jan and Mehta, Manish and Verhoeven, Eric and Larzon, Thomas and Gennai, Stefano and Coppi, Gioacchino and Lipsitz, Evan and Gargiulo, Nicholas and van der Vliet, J and Blankensteijn, Jan and Buth, Jacob and Lee, W and Biasi, Giorgio and Deleo, Gaetano and Kasirajan, Karthikeshwar and Moore, Randy and Soong, Chee and Cayne, Neal and Farber, Mark and Raithel, Dieter and Greenberg, Roy and van Sambeek, Marc and Brunkwall, Jan and Rockman, Caron and Hinchliffe, Robert},
  issn         = {1528-1140},
  language     = {eng},
  month        = {10},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Annals of Surgery},
  title        = {Collected World and Single Center Experience With Endovascular Treatment of Ruptured Abdominal Aortic Aneurysms.},
  url          = {http://dx.doi.org/10.1097/SLA.0b013e3181bdd7f5},
  year         = {2009},
}