Change in aneurysm diameter after stent-graft repair of ruptured abdominal aortic aneurysms.
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.
Arya
Nityanand
N
Regional Vascular & Endovascular Unit, Belfast City Hospital, Northern Ireland, UK. nityaarya@aol.com
Lee
Bernard
B
Loan
William
W
Johnston
Lynn Christie
LC
Boyd
Christopher Sydney
CS
Hannon
Raymond Joseph
RJ
Soong
Chee Voon
CV
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