Operative Mortality and Morbidity in Ruptured Abdominal Aortic Aneurysms in the Endovascular Age

Acher, Charles W.; Ramirez, Maria Camila Castello; Wynn, Martha M.

doi:10.1016/j.avsg.2019.10.073

Cited by 18 publications

(20 citation statements)

References 19 publications

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“…Nowadays, about 85% of AAA repairs are performed electively for intact aneurysms, though there are significant regional variations [ 250 ]. Naturally, a ruptured AAA is a surgical emergency that requires immediate repair, with a significant mortality of up to 85% [ 251 , 252 ].…”

Section: Diagnosis and Managementmentioning

confidence: 99%

“…Both OSR and EVAR can be used for rAAA repair, with EVAR being the method of choice if anatomically feasible. EVAR and open surgery for rAAA have comparable morbidity rates and show no difference in cardiac or respiratory failure [ 251 ]. Reintervention rates are similar, as well, and EVAR is consistently associated with faster discharge and a gain in quality-adjusted life years, rendering it cost-effective [ 309 ].…”

Section: Diagnosis and Managementmentioning

confidence: 99%

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AAA Revisited: A Comprehensive Review of Risk Factors, Management, and Hallmarks of Pathogenesis

et al. 2022

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Despite declining incidence and mortality rates in many countries, the abdominal aortic aneurysm (AAA) continues to represent a life-threatening cardiovascular condition with an overall prevalence of about 2–3% in the industrialized world. While the risk of AAA development is considerably higher for men of advanced age with a history of smoking, screening programs serve to detect the often asymptomatic condition and prevent aortic rupture with an associated death rate of up to 80%. This review summarizes the current knowledge on identified risk factors, the multifactorial process of pathogenesis, as well as the latest advances in medical treatment and surgical repair to provide a perspective for AAA management.

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Section: Diagnosis and Managementmentioning

confidence: 99%

Section: Diagnosis and Managementmentioning

confidence: 99%

AAA Revisited: A Comprehensive Review of Risk Factors, Management, and Hallmarks of Pathogenesis

et al. 2022

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“…Studies thus far have generally shown a greater preference for OSR in hemodynamically unstable patients while more stable patients including those with contained rupture were generally considered for EVAR [ 15 ]. In this study which included 20 patients, there were no significant differences in the hemodynamic status between the 2 groups.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of emergency endovascular versus open repair for abdominal aortic aneurysm rupture

Choo

Jeon

et al. 2021

Ann Surg Treat Res

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Purpose Ruptured abdominal aortic aneurysm (rAAA) is one of the most common aortic emergencies in vascular surgery and is associated with high operative mortality and morbidity rates despite recent treatment advances. We evaluated operative mortality risks for the outcomes of emergency endovascular aneurysm repair (eEVAR) vs. open repair in rAAA. Methods Twenty patients underwent eEVAR (n = 12) or open repair (n = 8) for rAAA between 2016 and 2020. We adopted the EVAR first strategy since 2018. Primary endpoints included in-hospital mortality and 1-year survival. The outcome variables were analyzed with Fisher exact, Mann-Whitney test, and linear by linear association. The Kaplan-Meier method was used to estimate survival. Results There were 13 males (65.0%) and the median age of the study cohort was 78.0 years (range, 49–88 years). In-hospital mortality occurred in 7 patients (35.0%); 5 (50.0%) in the early period and 2 (20.0%) in the later period of this series. According to the procedure type, 4 (50.0%) and 3 (25.0%) in-hospital mortalities occurred in the open repair and eEVAR patients, respectively. In 6 patients (50.0%), eEVAR was performed on unfavorable anatomy. The 1-year survival of eEVAR vs. open repair group was 75% ± 12.5% and 50% ± 17.7%, respectively. On univariate analysis, preoperative high-risk indices, postoperative acute renal failure requiring dialysis, pulmonary complications, and prolonged mechanical ventilation were associated with higher operative mortality. Conclusion The current data showed relatively superior outcomes with eEVAR vs. open repair for rAAA, even in some patients with unfavorable anatomy supporting the feasibility, efficacy, and safety of EVAR first strategy.

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“…Intenzivne resuscitacione mere kod hipotenzivnih bolesnika sa RAAA ponekad mogu da budu čak i fatalne [34][35][36]. Agresivna nadoknada volumena kod takvih bolesnika može imati za posledicu da nakon privremeno savladane tamponade u retroperitoneumu dođe do novog krvarenja, koje ukoliko se dogodi pre dolaska bolesnika u operacionu salu, može imati letalan ishod.…”

Section: Osnovni Principi Reanimacije I Tretmana Tokom Prvog Kontaktaunclassified

“…Presudan faktor za poboljšanje rezultata lečenja RAAA je vreme, iz čega proizilazi da bi u inicijalnom tretmanu ovakvih bolesnika trebalo da postoji jasno definisana vremenska linija što zahteva uvođenje posebnih protokola za ovakve slučajeve [34][35][36]. Prema Vodiču udruženja za vaskularnu hirurgiju, preporučeno ciljno vreme od prvog kontakta sa bolesnikom do uspostavljanja hemostaze iznosi 90 minuta [40].…”

Section: Osnovni Principi Reanimacije I Tretmana Tokom Prvog Kontaktaunclassified

The emergency medical team's role in initial treatment and transport of patients with abdominal aortic aneurysm rupture

Crnokrak¹,

Čolaković²,

Zdravkovic³

et al. 2019

NČ urgent medic Halo 194

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Operative Mortality and Morbidity in Ruptured Abdominal Aortic Aneurysms in the Endovascular Age

Cited by 18 publications

References 19 publications

AAA Revisited: A Comprehensive Review of Risk Factors, Management, and Hallmarks of Pathogenesis

AAA Revisited: A Comprehensive Review of Risk Factors, Management, and Hallmarks of Pathogenesis

Outcomes of emergency endovascular versus open repair for abdominal aortic aneurysm rupture

The emergency medical team's role in initial treatment and transport of patients with abdominal aortic aneurysm rupture

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