Key result
Secondary EVAR for ruptured abdominal aortic aneurysms after previous EVAR was associated with lower in-hospital mortality compared to open surgical repair (9.1% vs 63.6%, P=0.02).
Why the study?
Does secondary EVAR improve in-hospital mortality compared to open surgical repair in patients with ruptured abdominal aortic aneurysms after previous EVAR?
Observational (n=22)
Yes
Does secondary EVAR improve in-hospital mortality compared to open surgical repair in patients with ruptured abdominal aortic aneurysms after previous EVAR?
Absolute Event Rate: 9.1% vs 63.6%
p-value: p=.02
Rupture after EVAR is an increasingly frequent clinical entity often associated with endoleaks, migration, and poor follow-up compliance, though secondary EVAR may offer lower in-hospital mortality than open repair.
A total of 22 patients with ruptured abdominal aortic aneurysms (rAAAs) after previous endovascular aortic repair (EVAR; rAAAevar) were presented to 7 referral hospitals in Greece, between January 2006 and April 2012. Type Ia endoleak and endograft migration were identified in 72.7% and 50%, respectively. Compliance to follow-up protocol prior to rupture was 31.8%. In-hospital mortality was 36.4% (9.1% for those treated with secondary EVAR and 63.6% for those treated with open surgical repair, P = .02). An increase in the proportion of patients with rAAAevar among the total number of patients with rAAAs from 1.3% in 2007 to 18.2% in 2012 (P for trend = .04) was recorded, corresponding to an annual increase of 2.8% (b = 2.84, P = .04). Rupture after EVAR seemed to be a clinical entity encountered with increasing frequency over the past years. Type I endoleak and endograft migration were most frequently observed, whereas compliance to follow-up was low.
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Antonopoulos et al. (2014) conducted an observational in Ruptured abdominal aortic aneurysms after previous endovascular aortic repair (n=22). Secondary EVAR vs. Open surgical repair was evaluated on In-hospital mortality (p=.02). Secondary EVAR for ruptured abdominal aortic aneurysms after previous EVAR was associated with lower in-hospital mortality compared to open surgical repair (9.1% vs 63.6%, P=0.02).
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