Ruptured abdominal aortic aneurysm: endovascular or open approach in a Dutch general hospital

J Cardiovasc Surg (Torino). 2011 Jun;52(3):363-9.

Abstract

Aim: We compared the outcomes of 56 patients with a ruptured abdominal aortic aneurysm (RAAA) who underwent either open repair or emergency endovascular aneurysm repair (eEVAR) in a general hospital. It seems feasible that the availability of eEVAR for treatment of RAAA could lead to a decrease in hospital mortality.

Methods: We analyzed all admitted patients with a RAAA, between January 2006 and April 2008, eEVAR is compared to open repair. We studied 30 days mortality, intensive care unit stay, hospital stay, total blood loss and complications.

Results: Fifteen eEVAR procedures (26.8%) were performed. Mortality in the eEVAR-group was 26%, in the open repair-group 46%. Mean intensive care unit stay was 3.9 days and 4.8 days in the eEVAR-group and open repair-group, respectively. Mean hospital stay was 13 days and 10.5 days. The average blood loss was 210cc and 2760cc. The amount of blood products for transfusion was significantly higher in the open repair. Overall complication rate was not significantly different in both treatment groups.

Conclusion: Treatment in a Dutch general hospital of a RAAA with an eEVAR procedure has a lower mortality in comparison to the open repair. Therefore, whenever possible the eEVAR is the preferred treatment method.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aortic Aneurysm, Abdominal / diagnostic imaging
  • Aortic Aneurysm, Abdominal / mortality
  • Aortic Aneurysm, Abdominal / surgery*
  • Aortic Rupture / diagnostic imaging
  • Aortic Rupture / mortality
  • Aortic Rupture / surgery*
  • Aortography / methods
  • Blood Loss, Surgical / prevention & control
  • Blood Transfusion
  • Blood Vessel Prosthesis Implantation* / adverse effects
  • Blood Vessel Prosthesis Implantation* / mortality
  • Chi-Square Distribution
  • Endovascular Procedures* / adverse effects
  • Endovascular Procedures* / mortality
  • Female
  • Hospital Mortality
  • Hospitals, General*
  • Humans
  • Intensive Care Units
  • Length of Stay
  • Male
  • Netherlands
  • Postoperative Hemorrhage / etiology
  • Postoperative Hemorrhage / therapy
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome