Abdominal Aortic Aneurysm Research Today is a free monthly online journal that collates and summarizes the latest research about Abdominal Aortic Aneurysm, including details on aaa (abdominal aortic aneurism), cardiac disease, treatment, symptoms, surgery.

Percutaneous endovascular repair of ruptured abdominal aortic aneurysms.

Najjar SF, Mueller KH, Ujiki MB, Morasch MD, Matsumura JS, Eskandari MK

Division of Vascular Surgery, Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA.

HYPOTHESIS: Percutaneous endovascular repair of ruptured abdominal aortic aneurysms (RAAAs) has better outcomes than traditional open surgical repair. DESIGN: Single-center retrospective review. SETTING: University hospital tertiary referral center. PATIENTS: Thirty-seven RAAAs treated using endovascular repair (n = 15) or open surgery (n = 22). INTERVENTIONS: From January 1, 2000, through December 31, 2005, 15 RAAAs were treated with endovascular stent graft exclusion using commercially available systems. Twenty-two other patients undergoing standard open surgical repair during the same interval comprised a control group for comparison. MAIN OUTCOME MEASURES: Early outcomes of percutaneous endovascular repair of RAAAs. RESULTS: Among the endovascular group, the mean +/- SD age was 73 +/- 9.8 years, 86.6% were men (n = 13), and 20.0% had a preoperative systolic blood pressure of 80 mm Hg or lower (n = 3). An entirely percutaneous procedure was performed in the final 11 patients using arterial closure systems. Technical success of attempted endovascular exclusion was 100.0%. The mean +/- SD procedure time (107 +/- 30 minutes), transfusion requirements (6.6 +/- 4.7 U), and length of stay (3.0 +/- 6.8 days) were statistically significantly reduced compared with open surgery. The 30-day mortality was 6.7% (1 of 15) compared with an open surgery 30-day mortality of 13.6% (3 of 22). No late complications (pseudoaneurysm, infection, lymphocele, or neuropathy) occurred after a completely percutaneous technique during a mean follow-up of 12 months. CONCLUSION: Percutaneous endovascular repair of RAAAs is a more expedient and less morbid alternative than open surgical repair.

Published 20 November 2007 in Arch Surg, 142(11): 1049-52.
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