title: Anatomical suitability of ruptured abdominal aortic aneurysms for endovascular repair.
abstract: OBJECTIVE
  To assess the anatomical suitability of ruptured abdominal aortic aneurysms (AAA) for emergency endovascular repair.
  
  
  METHODS
  All cases (46 patients [35 men; mean age 74 years, range 54-85]) in which computed tomographic angiography (CTA) confirmed AAA rupture over a 5-year period at our university hospital were reviewed for anatomical suitability for endovascular repair. Measurements were made by a radiologist experienced in anatomical assessment of CT criteria for elective endovascular aneurysm repair (EVAR).
  
  
  RESULTS
  The mean aneurysm neck length was 18 mm (range 0-59); 17 were conical, 13 straight, 4 barrel, and 6 reverse conical. Six cases had no proximal neck. Overall, 37 (80%) patients were unsuitable for EVAR according to our criteria. Nearly half the patients (22, 48%) had > or =2 adverse features. Unsuitable neck morphology (35, 76%) was the primary reason for exclusion, but CIA aneurysm (10, 22%) and EIA tortuosity (7, 15%) were secondary adverse features.
  
  
  CONCLUSIONS
  With current stent-graft design, the majority of ruptured abdominal aortic aneurysms are anatomically unsuitable for endovascular repair.
authors.affiliation: University Hospital Nottingham, England, UK. danroseuk@ntlworld.com
authors.forename: Daniel F G
authors.initials: DF
authors.lastname: Rose
authors.forename: Ian R
authors.initials: IR
authors.lastname: Davidson
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Hinchliffe
authors.forename: Simon C
authors.initials: SC
authors.lastname: Whitaker
authors.forename: Roger H
authors.initials: RH
authors.lastname: Gregson
authors.forename: Shane T
authors.initials: ST
authors.lastname: MacSweeney
authors.forename: Brian R
authors.initials: BR
authors.lastname: Hopkinson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty; D017544:Aortic Aneurysm, Abdominal / Q000473:pathology* / Q000601:surgery*; D001019:Aortic Rupture / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged