Percutaneous endovascular repair of ruptured abdominal aortic aneurysms.
OBJECTIVE
Percutaneous endovascular repair of ruptured abdominal aortic aneurysms (RAAAs) has better outcomes than traditional open surgical repair.


METHODS
Single-center retrospective review.


METHODS
University hospital tertiary referral center.


METHODS
Thirty-seven RAAAs treated using endovascular repair (n = 15) or open surgery (n = 22).


METHODS
From January 1, 2000, through December 31, 2005, 15 RAAAs were treated with endovascular stent graft exclusion using commercially available systems. Twenty-two other patients undergoing standard open surgical repair during the same interval comprised a control group for comparison.


METHODS
Early outcomes of percutaneous endovascular repair of RAAAs.


RESULTS
Among the endovascular group, the mean +/- SD age was 73 +/- 9.8 years, 86.6% were men (n = 13), and 20.0% had a preoperative systolic blood pressure of 80 mm Hg or lower (n = 3). An entirely percutaneous procedure was performed in the final 11 patients using arterial closure systems. Technical success of attempted endovascular exclusion was 100.0%. The mean +/- SD procedure time (107 +/- 30 minutes), transfusion requirements (6.6 +/- 4.7 U), and length of stay (3.0 +/- 6.8 days) were statistically significantly reduced compared with open surgery. The 30-day mortality was 6.7% (1 of 15) compared with an open surgery 30-day mortality of 13.6% (3 of 22). No late complications (pseudoaneurysm, infection, lymphocele, or neuropathy) occurred after a completely percutaneous technique during a mean follow-up of 12 months.


CONCLUSIONS
Percutaneous endovascular repair of RAAAs is a more expedient and less morbid alternative than open surgical repair.
Najjar
Samer F
SF
Division of Vascular Surgery, Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA.
Mueller
Kyle H
KH
Ujiki
Michael B
MB
Morasch
Mark D
MD
Matsumura
Jon S
JS
Eskandari
Mark K
MK
D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001019:Aortic Rupture / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents