Endovascular stent-graft repair of ruptured aortic aneurysms.
OBJECTIVE
To demonstrate the endovascular approach to the management of ruptured abdominal aortic aneurysms (AAA).


METHODS
From 1995 to 2001, 24 patients (21 men; mean age 69 years, range 26-92) underwent emergency endovascular treatment for ruptured AAA. The average interval between onset of symptoms and admission to the hospital was 8.0 hours; the mean time between admission and the operation was 2.3 hours. No suprarenal occluding catheter was used. The stent-graft configurations were 19 bifurcated, 4 tube, and 1 aortomonoiliac.


RESULTS
Stent-graft placement was successful in 23 (96%) cases. Failed limb extension deployment prompted conversion to open surgery in the remaining patient. One case was converted to open surgery. Mean duration of treatment was 122 minutes. Three (12.5%) patients died in-hospital. The median hospital stay was 12 days. The rate of endoleaks (all type I) was 16.7%. The overall technical success rate was 77%. The 3-year actuarial survival rate was 75%.


CONCLUSIONS
Our experience shows excellent results in emergency patients with ruptured AAAs treated with endovascular surgery. In order to verify these promising results, a broader-scale clinical study must be conducted.
Scharrer-Pamler
Reinhard
R
Department for Thoracic and Vascular Surgery, Ulm University Hospital, Ulm, Germany. reinhard.pamler@medizin.uni-ulm.de
Kotsis
Thomas
T
Kapfer
Xaver
X
Görich
Johannes
J
Sunder-Plassmann
Ludger
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001019:Aortic Rupture / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D002985:Clinical Protocols; D004638:Emergency Treatment; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000628:therapy; D015607:Stents