Endovascular versus conventional open repair of acute abdominal aortic aneurysm: feasibility and preliminary results.
OBJECTIVE
To evaluate the feasibility of endovascular treatment of acute abdominal aortic aneurysm (AAA) with commercially prepared bifurcated systems.


METHODS
From January through July 2001, 22 patients (17 men; mean age 73.6 years, range 59-89) were referred with an acute (symptomatic/ruptured) AAA. Six patients were treated with emergent open surgery because of hemodynamic instability, but the other 16 patients underwent computed tomographic angiography with multidirectional reconstruction. Six (27%) aneurysms were suitable for endovascular repair (EVR) and were successfully treated. Procedural variables, morbidity, and mortality were compared between the EVR group and 6 patients of equivalent hemodynamic status from among the conventionally treated patients.


RESULTS
There was no mortality in either group. The median aneurysm diameter in the EVR group was 63 mm (range 48-84) versus 80 mm (45-82) in the matched surgically treated AAAs (p=0.628). Procedural duration was 193 minutes (150-265) for the EVR group compared to 203 minutes (130-270) for the matched group (p=0.630). Median blood loss was significantly less (p=0.010) in the EVR group (125 versus 3400 mL). Median length of stay (LOS) in intensive care was 8 hours (0-21) versus 62 hours (48-112) for the surgical group (p=0.004). Hospital LOS was significantly reduced (p=0.024) for the EVR patients (7.5 [2-16] versus 15.5 [10-34] days).


CONCLUSIONS
Endovascular treatment of acute aneurysm is feasible, and preliminary results are promising.
van Sambeek
Marc R H M
MR
Department of Vascular Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands. vansambeek@hlkd.azr.nl
van Dijk
Lukas C
LC
Hendriks
Johanna M
JM
van Grotel
Martine
M
Kuiper
Jan-Willem
JW
Pattynama
Peter M T
PM
van Urk
Hero
H
D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014656:Vascular Surgical Procedures