Favorable discharge disposition and survival after successful endovascular repair of ruptured abdominal aortic aneurysm

Abstract

We have previously demonstrated that successful utilization of rEVAR improves the early survival of rAAA patients compared with OSR. This study shows that more patients are able to be discharged to home after rEVAR and that the early survival advantage is continued in midterm follow-up, suggesting that rEVAR should be attempted first when feasible. Further studies are needed to determine the long-term durability of endovascular repair in the management of rAAA as well as the impact on cost and long-term quality of life.

Association of an Endovascular-First Protocol for Ruptured Abdominal Aortic Aneurysms With Survival and Discharge Disposition

“…Our current treatment protocol for patients with an rAAA is similar to those previously published 2,4,10,11 and is highlighted in Figure 1. A rapid clinical assessment stratified patients into 1 of 2 groups based on physiologic parameters.…”

“…Nevertheless, acceptance of rE-VAR has gained considerable momentum in recent years owing to an increasing body of literature showing rEVAR to be associated with improved perioperative and early survival among patients presenting with an rAAA. [2][3][4][5][6][7] These reports, however, are limited mostly to retrospective and observational data, with the few studies examining midterm outcomes noting mixed results. 8,9 Consistent with national trends, use of rEVAR has steadily increased at our institution in recent years, and this lessinvasive treatment strategy was formally integrated into a structured algorithmic approach to the management of patients with an rAAA at our institution in 2007.…”

Morbimortalidad de los aneurismas de aorta abdominal rotos durante la implantación del tratamiento endovascular en nuestro centro

“…La mortalidad global y por técnica quirúrgica empleada de nuestra serie es similar a la publicada en la bibliografía 10,13 . En el grupo tratado mediante cirugía abierta, obtenemos una mayor mortalidad, ya que estos pacientes presentan mayor inestabilidad hemodinámica, anatomía desfavorable y localización yuxtarrenal.…”

Midterm Re-interventions and Survival After Endovascular Versus Open Repair for Ruptured Abdominal Aortic Aneurysm

“…One study 13 reported similar survival rates, whereas other studies reported lower survival rates for EVAR. 11,12,14,15 It appears probable that patient selection for EVAR significantly influences these midterm survival rates. Because randomised treatment allocation adjusts for this patient selection, the results of the subgroup analysis in the AJAX trial guide us towards the conclusion that the midterm survival rates for EVAR and for OR are comparable.…”