Early and intermediate outcome of emergency endovascular aneurysm repair of ruptured infrarenal aortic aneurysm: a single-centre experience of 90 consecutive patients.
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.
Holst
J
J
Vascular Centre Malmö-Lund, Malmö University Hospital, S-205 02 Malmö, Sweden. jan.holst@med.lu.se
Resch
T
T
Ivancev
K
K
Björses
K
K
Dias
N
N
Lindblad
B
B
Mathiessen
S
S
Sonesson
B
B
Malina
M
M
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