Endovascular Ruptured Abdominal Aortic Aneurysm Repair (EVRAR): A Systematic Review

Harkin, Denis W.; Dillon, Marianne; Blair, Paul; Ellis, Peter; Kee, Frank

doi:10.1016/j.ejvs.2007.06.004

Cited by 80 publications

(40 citation statements)

References 75 publications

(42 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, eEVAR provides improved operative mortality rates with shorter hospital and ICU stays [20]. This present study investigated and compared the effect of eOR to eEVAR on the dysfunction of various organs.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Endovascular Repair of Ruptured Abdominal Aortic Aneurysm on the Gastrointestinal and Renal Function

Makar

Badger

O’Donnell

et al. 2014

International Journal of Vascular Medicine

View full text Add to dashboard Cite

Introduction. Systemic effects of ruptured abdominal aortic aneurysm (rAAA) may be altered by the mode of surgery. This study aimed to determine systemic effects of endovascular aneurysm repair (EVAR) compared to open repair (OR). Patients and Methods. Consecutive patients with rAAA were repaired by OR or EVAR according to computerised tomographic (CT) findings. Renal function was monitored by estimated glomerular filtration rate (eGFR), serum urea and creatinine, and urinary albumin creatinine ratio (ACR). Hepatic function was assessed postoperatively for 5 days. Intestinal function was determined by the paracetamol absorption test. Intestinal permeability was assessed by urinary lactulose/mannitol ratio. Results. 30 rAAA patients were included. Fourteen had eEVAR and sixteen eOR. Serum urea were higher in eOR, while creatinine was similar between groups. Hepatic function showed no intergroup difference. Paracetamol absorption was increased in eEVAR group at day 3 compared to day 1 (P = 0.03), with no similar result in eOR (P = 0.24). Peak lactulose/mannitol ratio was higher in eOR (P = 0.03), with higher urinary L/M ratio in eOR at day 3 (P = 0.02). Clinical intestinal function returned quicker in eEVAR (P = 0.02). Conclusion. EVAR attenuated the organ dysfunction compared to open repair. However, a larger comparative trial would be required to validate this. The clinical trial is registered with reference number EUDRACT: 2013-003373-12.

show abstract

Section: Discussionmentioning

confidence: 99%

The Impact of Endovascular Repair of Ruptured Abdominal Aortic Aneurysm on the Gastrointestinal and Renal Function

Makar

Badger

O’Donnell

et al. 2014

International Journal of Vascular Medicine

View full text Add to dashboard Cite

show abstract

“…Unfortunately, because of differences in interventional experience levels amongst physicians, anatomical inclusion criteria for EVAR still vary widely amongst medical centres, with eligibility rates ranging from 34 to 100 % [51]. Most studies, however, report eligibility rates over 50 % [52–55].…”

Section: Managementmentioning

confidence: 99%

“…Over half of the patients do not reach the hospital alive [37, 58]. Even for those who are able to undergo open surgical repair, the mortality rate remains higher than 40 % [51–53]. …”

Section: Outcomementioning

confidence: 99%

See 1 more Smart Citation

Rupture signs on computed tomography, treatment, and outcome of abdominal aortic aneurysms

Kaitoukov

Morin-Roy

et al. 2014

Insights Imaging

View full text Add to dashboard Cite

ObjectivesAbdominal aortic aneurysm (AAA) rupture has a high mortality rate. Although the diagnosis of a ruptured AAA is usually straightforward, detection of impending rupture signs can be more challenging. Early diagnosis of impending AAA rupture can be lifesaving. Furthermore, differentiating between impending and complete rupture has important repercussions on patient management and prognosis. The purpose of this article is to classify and illustrate the entire spectrum of AAA rupture signs and to review current treatment options for ruptured AAAs.MethodsUsing medical illustrations supplemented with computed tomography (CT), this essay showcases the various signs of impending rupture and ruptured AAAs. Endovascular aneurysm repair (EVAR) and open surgical repair are also discussed as treatment options for ruptured AAAs.ResultsCT imaging findings of ruptured AAAs can be categorised according to location: intramural, luminal, and extraluminal. Intramural signs generally indicate impending AAA rupture, whereas luminal and extraluminal signs imply complete rupture. EVAR has emerged as an alternative and possibly less morbid method to treat ruptured AAAs.ConclusionsAAA rupture occurs at the end of a continuum of growth and wall weakening. This review describes the CT imaging findings that may help identify impending rupture prior to complete rupture.Teaching PointsAAA rupture occurs at the end of a continuum of growth and wall weakening.Intramural imaging findings indicate impending AAA rupture.Luminal and extraluminal imaging findings imply complete AAA rupture.Some imaging findings are not specific to AAA ruptures and can be seen in other pathologies.EVAR has emerged as an alternative and possibly less morbid method of treating ruptured AAAs.

show abstract

“…The figures found in the literature regarding the non-modifiable risk-factors, as advanced age and gender, are conflicting ([4, 7, 12, 20, 28, 32]). Our patients had an average age of 73, and 42% were ≥75 years old (Table 3).…”

Section: Non-modifiable Risk-factorsmentioning

confidence: 99%

Open surgery in endovascular aneurysm repair era: simplified classification in two risk groups owing to factors affecting mortality in 137 ruptured abdominal aortic aneurysms (RAAAs)

Bonardelli¹,

Cervi

Maffeis

et al. 2011

Updates Surg

View full text Add to dashboard Cite

Our objective is to identify in 137 true RAAAs operated consecutively in open surgery: (1) diagnostic therapeutic aspects capable of influencing results, (2) risk classes with different prognosis, (3) any situations where the prognosis is so negative that surgery is not recommended. The relationship of 16 anamnestic, clinical and technical parameters prospectively collected with 30-day mortality was retrospectively evaluated by uni- and multivariate analyses. Thirty-day mortality was 37%. The univariate analysis identified as mortality predictors Hb ≤ 8 g/dl and circulatory shock at hospitalisation, but following the multivariate analysis only circulatory shock was a certainly significant risk-factor. The cumulative effect on mortality of the two parameters identified at univariate analysis translates into a statistically significant difference in mortality between two groups of patients: A (no or just one risk-factor) and B (two risk-factors). To reinstate euvolemia, rather than adequate haemoglobin values, improves the chances of success. A simple prognostic index into two risk classes is feasible, but abstention from surgery is not justified in any type of patient.

show abstract

Endovascular Ruptured Abdominal Aortic Aneurysm Repair (EVRAR): A Systematic Review

Abstract: For the treatment of symptomatic or ruptured abdominal aortic aneurysm, emergency endovascular repair (EVRAR) is feasible in selected patients, with early outcomes comparable to best conventional open surgical repair for the treatment of RAAA.

Cited by 80 publications

References 75 publications

The Impact of Endovascular Repair of Ruptured Abdominal Aortic Aneurysm on the Gastrointestinal and Renal Function

The Impact of Endovascular Repair of Ruptured Abdominal Aortic Aneurysm on the Gastrointestinal and Renal Function

Rupture signs on computed tomography, treatment, and outcome of abdominal aortic aneurysms

Open surgery in endovascular aneurysm repair era: simplified classification in two risk groups owing to factors affecting mortality in 137 ruptured abdominal aortic aneurysms (RAAAs)

Contact Info

Product

Resources

About