Mid-term Outcomes following Emergency Endovascular Aortic Aneurysm Repair for Ruptured Abdominal Aortic Aneurysms

作者：Noorani A; Page A; Walsh S R; Varty K; Hayes P D; Boyle J R^*

来源：European Journal of Vascular and Endovascular Surgery, 2012, 43(4): 382-385.

DOI：10.1016/j.ejvs.2011.12.023

• Emergency endovascular aortic aneurysm
• repair
• Emergency EVAR

Objective: Emergency Endovascular Aortic Aneurysm Repair (eEVAR) is a rapidly evolving approach to ruptured Abdominal Aortic Aneurysms (rAAA). Yet longer-term outcomes following eEVAR remain unclear. This study compares mid-term outcomes of eEVAR and open rAAA.
Methods: A prospective database for all patients undergoing eEVAR and open rAAA from January 2006 to April 2010 was analysed. Patients were offered eEVAR if anatomically suitable.
Results: 52 patients (45 male, median age 78 years (62-92 years), underwent eEVAR, 50 patients (44 male, median age = 71 (62-95 years) underwent open rAAA repair. In-hospital mortalities were 12% (6/52) for eEVAR, 32% (16/50) for open repair. There were five re-interventions (10%) in the eEVAR group. The pen-operative survival benefits of eEVAR over open rAAA repair were maintained at 1 and 2 years post-operatively with open repair demonstrating a two-fold increased risk of mortality (Hazard ratio 2.2, Fisher Exact test, 95% Confidence Interval (CI) 1.108-4.62, p = 0.0122). Overall survival was 81% at 1 year, 73% at 2 years for eEVAR, and 62% at 1 year and 52% at 2 years for open rAAA repair.
Conclusion: EEVAR is associated with excellent mid-term survival in this cohort. We would recommend eEVAR as the management of choice for rAAA in anatomically suitable patients where local facilities and expertise exist.

• 出版日期2012-4