Key result
Endovascular aneurysm repair for ruptured AAA demonstrated an average post-operative mortality rate of 24% and an anatomic suitability rate of 58% to 80% in selected patients.
Why the study?
Does endovascular aneurysm repair (EVAR) reduce peri-operative mortality compared to conventional open repair in patients with ruptured abdominal aortic aneurysm?
Does endovascular aneurysm repair (EVAR) reduce peri-operative mortality compared to conventional open repair in patients with ruptured abdominal aortic aneurysm?
EVAR is a feasible therapeutic option for ruptured AAA in anatomically suitable and hemodynamically stable patients, with an average post-operative mortality of 24%.
May support EVAR consideration in selected cases; leaves open randomized mortality comparison to open repair.
The reduced physiological impact of endovascular aneurysm repair (EVAR) compared with conventional open repair has been demonstrated. If this technique could be used routinely in patients with ruptured abdominal aortic aneurysm (AAA) it may reduce the high peri-operative mortality. This review of the literature identified the current experience with EVAR of ruptured AAA. Only a small number of case series with selected patients are reported. These patients were selected for their haemodynamic stability, and their suitable aneurysm morphology. The overall anatomic suitability rates for EVAR reported, suggest an applicability of 58% to 80% from an intent-to-treat experience. The average post-operative mortality rate was 24%, ranging from 9 to 45% and may reflect increasing experience and patient selection. Important lessons have been learned from these first experiences that help to define a clear position of EVAR as an additional therapeutic option for ruptured AAA.
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Alsac et al. (2005) conducted a review in ruptured abdominal aortic aneurysm (AAA). Endovascular aneurysm repair (EVAR) vs. conventional open repair was evaluated on post-operative mortality rate. Endovascular aneurysm repair for ruptured AAA demonstrated an average post-operative mortality rate of 24% and an anatomic suitability rate of 58% to 80% in selected patients.
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