Key result
Emergency endovascular aneurysm repair for ruptured abdominal aortic aneurysms showed a 30-day mortality of 11% versus 32% for open aneurysm repair (p = not significant).
Why the study?
Does emergency endovascular aneurysm repair reduce mortality in patients with ruptured abdominal aortic aneurysms compared to open aneurysm repair?
Cohort (n=47)
Does emergency endovascular aneurysm repair reduce mortality in patients with ruptured abdominal aortic aneurysms compared to open aneurysm repair?
Absolute Event Rate: 11% vs 32%
p-value: p=not significant
Emergency endovascular aneurysm repair for ruptured abdominal aortic aneurysms suggests a potential early survival advantage over open repair, though differences were not statistically significant in this small cohort.
Potential early mortality benefit with emergency EVAR for ruptured AAA not statistically confirmed; leaves open need for randomized evidence.
We present the early results of a policy of treating all anatomically suitable ruptured abdominal aortic aneurysms (rAAAs) by emergency endovascular aneurysm repair (eEVAR), regardless of hemodynamic instability. Data were retrospectively collected from prospectively maintained databases identifying patients with rAAA from 2006 to 2007. Forty-seven patients with true rAAA were identified (87% men; median age 76 years [range 63-97 years]), of whom 18 (38%) were treated with eEVAR, 19 (40%) received open aneurysm repair (OAR), and 10 (21%) were managed nonoperatively. Fifteen of 18 (83%) eEVAR patients received an aortouni-iliac device + femorofemoral crossover, 2 patients (11%) had bifurcated devices, and 1 patient (6%) had a new iliac limb. Thirty-day mortality was 11% (2 of 18) for eEVAR and 32% (6 of 19) for OAR (p = not significant). At the 6-month follow-up, mortality was 22% (4 of 18) for eEVAR and 37% (7 of 19) for OAR (p = not significant). A clinically significant early survival advantage is suggested for eEVAR in patients presenting with rAAA.
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Lyons et al. (2010) conducted a cohort in ruptured abdominal aortic aneurysms (rAAAs) (n=47). Emergency endovascular aneurysm repair (eEVAR) vs. Open aneurysm repair (OAR) was evaluated on 30-day mortality (p=not significant). Emergency endovascular aneurysm repair for ruptured abdominal aortic aneurysms showed a 30-day mortality of 11% versus 32% for open aneurysm repair (p = not significant).
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