title: Change in aneurysm diameter after stent-graft repair of ruptured abdominal aortic aneurysms.
abstract: OBJECTIVE
  To compare the changes in aneurysm size following endovascular aneurysm repair (EVAR) for ruptured versus elective abdominal aortic aneurysms (AAA).
  
  
  METHODS
  Aneurysm sac diameter was measured from computed tomographic (CT) scans in 14 hemodynamically stable patients (14 men; mean age 74+/-7 years, range 60 to 83) prior to emergent stent-graft repair for ruptured AAA. The aneurysm diameter change was followed postprocedurally with serial CT and the outcomes compared to 74 AAA patients (58 men; mean age 74+/-7 years, range 56 to 87) having elective EVAR in the same time period. The mean rate of sac decrease (mm/month) was calculated for each group.
  
  
  RESULTS
  There were 3 postoperative deaths in the ruptured AAA cohort, leaving 11 patients available for follow-up analysis (mean 16 months, range 2-49). Eight (73%) patients with ruptured AAA demonstrated significantly decreased (>5 mm) aneurysm diameters compared with 32 (43%) elective cases (p=0.07) followed a mean 20 months (range 3-51). The mean rate of sac diameter decrease was 1.50+/-1.03 mm/month in the rupture group versus 0.73+/-0.86 mm/month in the elective group (p=0.04).
  
  
  CONCLUSIONS
  This study suggests that ruptured AAAs treated with stent-graft experience sac regression at a higher rate compared with electively treated AAA. The reasons for these findings remain unclear.
authors.affiliation: Regional Vascular & Endovascular Unit, Belfast City Hospital, Northern Ireland, UK. nityaarya@aol.com
authors.forename: Nityanand
authors.initials: N
authors.lastname: Arya
authors.forename: Bernard
authors.initials: B
authors.lastname: Lee
authors.forename: William
authors.initials: W
authors.lastname: Loan
authors.forename: Lynn Christie
authors.initials: LC
authors.lastname: Johnston
authors.forename: Christopher Sydney
authors.initials: CS
authors.lastname: Boyd
authors.forename: Raymond Joseph
authors.initials: RJ
authors.lastname: Hannon
authors.forename: Chee Voon
authors.initials: CV
authors.lastname: Soong
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000295:instrumentation*; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000628:therapy*; D001019:Aortic Rupture / Q000000981:diagnostic imaging / Q000628:therapy*; D001027:Aortography; D001807:Blood Vessel Prosthesis; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D015607:Stents; D014057:Tomography, X-Ray Computed