What question did this study set out to answer?

To compare technical success, mortality, and complication rates between endovascular aneurysm repair (EVAR) and open surgery in patients diagnosed with ruptured abdominal aortic aneurysms.

October 1, 2005Journal of Endovascular Therapy

Endovascular Treatment of Ruptured Abdominal Aortic Aneurysms: A Shift of the Paradigm?

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Why the study?

Does endovascular aneurysm repair (EVAR) reduce mortality compared to open surgery in patients with ruptured abdominal aortic aneurysms?

Population

50 patients diagnosed with ruptured abdominal aortic aneurysms, including 15 undergoing EVAR, 26 undergoing…

Comparison

Endovascular aneurysm repair (EVAR) vs Open surgery

Design

Cohort

Follow-up

30 days or in-hospital

Authors

TLThomas LarzonÖrebro University RLRickard LindgrenLinköping University LNLars NorgrenVascular / Pulmonary Vascular

Discussion

Member takes

Implication

EVAR should not yet change practice for ruptured AAA; leaves open whether endovascular repair improves survival and requires randomized confirmation.

Key Points

To compare technical success, mortality, and complication rates between endovascular aneurysm repair (EVAR) and open surgery in patients diagnosed with ruptured abdominal aortic aneurysms.
Analyzed 50 consecutive patients diagnosed with ruptured abdominal aortic aneurysms (rAAA) between May 2001 and January 2004, of whom 15 underwent EVAR, 26 underwent open surgery, and 9 were managed nonoperatively.
Evaluated 30-day or in-hospital mortality, complication rates, and the presence of circulatory shock (systolic blood pressure < 80 mmHg) alongside five defined clinical risk factors.
Mortality reached 13% (2/15) in the EVAR group compared to 46% (12/26) in the open surgery group (p > 0.05; unadjusted OR 5.4, 95% CI 0.9 to 58, p = 0.07; multivariate-adjusted OR 6.5, 95% CI 0.8 to 96, p = 0.08).
Postoperative complications occurred in 60% (9/15) of EVAR patients versus 85% (22/26) of open surgery patients (p = 0.13).
Aneurysm exclusion was achieved in 93% (14/15) of EVAR procedures, with 2 conversions (13%) to open surgery caused by intraoperative stent-graft migration and subsequent arterial dissection.

Structured PICO

Does endovascular aneurysm repair (EVAR) reduce mortality compared to open surgery in patients with ruptured abdominal aortic aneurysms?

Population

50 patients diagnosed with ruptured abdominal aortic aneurysms (rAAA), including 15 undergoing EVAR (median age 73, 14 men), 26 undergoing open surgery (median age 75, 23 men), and 9 not operated upon.

Intervention

Endovascular aneurysm repair (EVAR)

Comparator

Open surgery

Outcome

Mortality (defined as death within 30 days after operation, or in-hospital mortality if hospital stay exceeded 30 days)hard clinical

EVAR for ruptured abdominal aortic aneurysms is feasible and showed a non-significant trend toward lower mortality and complications compared to open surgery.

Cite This Study

Larzon et al. (2005) studied this question.

synapsesocial.com/papers/6a79ec6b14b028facf0e0ecd https://doi.org/10.1583/04-1469.1

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Implication

EVAR should not yet change practice for ruptured AAA; leaves open whether endovascular repair improves survival and requires randomized confirmation.

Endovascular Treatment of Ruptured Abdominal Aortic Aneurysms: A Shift of the Paradigm?

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Endovascular Treatment of Ruptured Abdominal Aortic Aneurysms: A Shift of the Paradigm?

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider