Ruptured abdominal aortic aneurysm: endovascular treatment.
BACKGROUND
This report describes our preliminary experience in endovascular management of 25 ruptured abdominal aortic aneurysms (rAAAs).


METHODS
In the past 3 years we treated 46 patients who had rAAA, and 25 (54.3%) were treated with an endovascular approach. Patients' mean age was 76 +/- 9 years. The diagnosis was confirmed by computed tomographic angiography in 23 patients (92%). Mean aneurysm diameter was 73 +/- 17 mm. We used an infrarenal bifurcated device in 17 patients (68%), a suprarenal bifurcated in four patients (16%), and an aortomonoiliac graft in four patients (16%). Overall, nine patients (36%) required intensive care. Every patient underwent radiologic follow-up according to the Eurostar register, with concomitant evaluation of the D-dimer level (cut-off <200 microg/L) as a biological marker for endoleaks.


RESULTS
The primary technical success rate was 100%. Overall in-hospital mortality rate was 20%. Mean hospitalization was 7 days (range, 3-30), and mean follow-up was 7 months. One occlusion (4%) of the iliac limb and two type II endoleaks (8%) occurred. The mean D-dimer level in type I endoleak was 1045 microg/L (range, 459-2021).


CONCLUSIONS
In our experience, endovascular management of rAAA is feasible and safe and produces better results than conventional surgery, provided the morphology is suitable and the procedure is carried out by an experienced endovascular team.
Castelli
P
P
Department of Surgery, University of Insubria, Ospedale di Circolo, 21100, Varese, Viale Borri 57, Italy. patrizio.castelli@uninsubria.it
Caronno
R
R
Piffaretti
G
G
Tozzi
M
M
Laganà
D
D
Carrafiello
G
G
Cuffari
S
S
Bacuzzi
A
A
D000368:Aged; D018681:Anesthetics, General; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation; D015897:Comorbidity; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D011474:Prosthesis Design; D011859:Radiography
D018681:Anesthetics, General