title: Early and intermediate outcome of emergency endovascular aneurysm repair of ruptured infrarenal aortic aneurysm: a single-centre experience of 90 consecutive patients.
abstract: OBJECTIVE
  To evaluate the early and intermediate outcome of a consecutive series of emergency endovascular aneurysm repairs (eEVAR) of computed tomography (CT)-verified infrarenal ruptured abdominal aortic aneurysm (rAAA) at a single tertiary referral centre.
  
  
  METHODS
  Prospectively collected data of patients operated between April 2000 and October 2007 were retrospectively reviewed and all their pre-, intra- and postoperative imaging were re-evaluated. Patient and procedural data were analysed using a Cox multiregression model.
  
  
  RESULTS
  Ninety patients (86% men, aged 76 (+/-7) years), were identified and included in the analysis. Symptom duration was <3h in 22% of patients, 3-24h in 39% and >24h in 39%. Mean aneurysmal diameter was 73 (+/-14)mm. All patients were treated with the COOK Zenith stent-graft (56% bi-iliac and 44% uni-iliac). Sixty-one percent were haemodynamically unstable on presentation, and 26% required an intra-operative aortic occlusion balloon to maintain haemodynamic stability. The 30-day and 1-year mortality rates were 27% and 37%, respectively. One-year aneurysm-related mortality was 33%. Twenty-eight percent of patients required re-interventions during the follow-up. The use of an aortic occlusion balloon and the presence of cerebrovascular disease or obstructive lung disorder correlated significantly with 30-day mortality in the multivariate analysis.
  
  
  CONCLUSIONS
  EVAR is a valid treatment option for rAAA when used as a first-line method for all patients.
authors.affiliation: Vascular Centre Malmö-Lund, Malmö University Hospital, S-205 02 Malmö, Sweden. jan.holst@med.lu.se
authors.forename: J
authors.initials: J
authors.lastname: Holst
authors.forename: T
authors.initials: T
authors.lastname: Resch
authors.forename: K
authors.initials: K
authors.lastname: Ivancev
authors.forename: K
authors.initials: K
authors.lastname: Björses
authors.forename: N
authors.initials: N
authors.lastname: Dias
authors.forename: B
authors.initials: B
authors.lastname: Lindblad
authors.forename: S
authors.initials: S
authors.lastname: Mathiessen
authors.forename: B
authors.initials: B
authors.lastname: Sonesson
authors.forename: M
authors.initials: M
authors.lastname: Malina
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000401:mortality / Q000628:therapy*; D001019:Aortic Rupture / Q000401:mortality / Q000628:therapy*; D021721:Balloon Occlusion; D001807:Blood Vessel Prosthesis; D002561:Cerebrovascular Disorders / Q000453:epidemiology; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology; D012189:Retrospective Studies; D015607:Stents