Key result
Coincidental procedures carry a 1.7% aneurysm rupture risk, linked to large diameter and hypertension.
Why the study?
The relationship between aortic aneurysmal rupture and coincidental surgical or endoscopic treatment was unclear, including the role of aneurysm size and perioperative hypertension control.
What is the incidence of aortic aneurysm rupture following coincidental surgical or endoscopic procedures in patients with known aortic aneurysmal disease?
Observational (n=118)
What is the incidence of aortic aneurysm rupture following coincidental surgical or endoscopic procedures in patients with known aortic aneurysmal disease?
Postoperative rupture of aortic aneurysms after coincidental procedures is rare but may be associated with larger aneurysm diameter and poor perioperative hypertension control.
Rupture after coincidental procedures is rare in aortic aneurysm patients; supports perioperative BP optimization for large aneurysms but leaves open causal risk.
The clinical course of 76 patients with aortic aneurysmal disease undergoing 107 coincidental surgical procedures was analysed in order to examine the relationship between aortic aneurysmal rupture and coincidental treatment. Additionally the incidence of aneurysmal rupture was assessed following 82 endoscopic procedures in 42 patients with aortic aneurysms. Two patients ruptured an aortic aneurysm after operation, one after colonoscopy (maximal transverse diameter 7 cm) and one after coronary artery bypass grafting (maximal transverse diameter 5.6 cm). The mean maximal transverse diameter of aneurysms in 76 patients was 5.08 cm (95% confidence interval 4.7-5.4 cm). Both patients with ruptured aortic aneurysm were outside these confidence limits and were known hypertensives whose perioperative control of hypertension was questionable. The present series of patients is discussed with reference to induction of collagenase activity as a precipitating cause for postoperative rupture of aortic aneurysms, perioperative control of hypertension, transverse aneurysm diameter as a predictor of postoperative rupture and conduct of coincidental procedures in the presence of aneurysmal disease.
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Nestor Lalak (1995) conducted an observational in Aortic aneurysmal disease (n=118). Coincidental surgical or endoscopic procedures was evaluated on Aneurysmal rupture. Coincidental surgical or endoscopic procedures in patients with aortic aneurysms were followed by aneurysmal rupture in 2 patients (1.7%), both associated with large aneurysm diameter and hypertension.
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