Why the study?
What proportion of ruptured abdominal aortic aneurysms are anatomically suitable for emergency endovascular repair?
What proportion of ruptured abdominal aortic aneurysms are anatomically suitable for emergency endovascular repair?
The majority of ruptured abdominal aortic aneurysms (80%) are anatomically unsuitable for endovascular repair with current stent-graft designs, primarily due to adverse neck morphology.
May limit emergency EVAR applicability; leaves open need for devices addressing neck anatomy in most ruptured AAAs.
PURPOSE: To assess the anatomical suitability of ruptured abdominal aortic aneurysms (AAA) for emergency endovascular repair. METHODS: All cases (46 patients [35 men; mean age 74 years, range 54-85]) in which computed tomographic angiography (CTA) confirmed AAA rupture over a 5-year period at our university hospital were reviewed for anatomical suitability for endovascular repair. Measurements were made by a radiologist experienced in anatomical assessment of CT criteria for elective endovascular aneurysm repair (EVAR). RESULTS: The mean aneurysm neck length was 18 mm (range 0-59); 17 were conical, 13 straight, 4 barrel, and 6 reverse conical. Six cases had no proximal neck. Overall, 37 (80%) patients were unsuitable for EVAR according to our criteria. Nearly half the patients (22, 48%) had > or =2 adverse features. Unsuitable neck morphology (35, 76%) was the primary reason for exclusion, but CIA aneurysm (10, 22%) and EIA tortuosity (7, 15%) were secondary adverse features. CONCLUSIONS: With current stent-graft design, the majority of ruptured abdominal aortic aneurysms are anatomically unsuitable for endovascular repair.
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Rose et al. (2003) studied this question.
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