title: Ruptured abdominal aortic aneurysm: endovascular or open approach in a Dutch general hospital.
abstract: OBJECTIVE
  We compared the outcomes of 56 patients with a ruptured abdominal aortic aneurysm (RAAA) who underwent either open repair or emergency endovascular aneurysm repair (eEVAR) in a general hospital. It seems feasible that the availability of eEVAR for treatment of RAAA could lead to a decrease in hospital mortality.
  
  
  METHODS
  We analyzed all admitted patients with a RAAA, between January 2006 and April 2008, eEVAR is compared to open repair. We studied 30 days mortality, intensive care unit stay, hospital stay, total blood loss and complications.
  
  
  RESULTS
  Fifteen eEVAR procedures (26.8%) were performed. Mortality in the eEVAR-group was 26%, in the open repair-group 46%. Mean intensive care unit stay was 3.9 days and 4.8 days in the eEVAR-group and open repair-group, respectively. Mean hospital stay was 13 days and 10.5 days. The average blood loss was 210cc and 2760cc. The amount of blood products for transfusion was significantly higher in the open repair. Overall complication rate was not significantly different in both treatment groups.
  
  
  CONCLUSIONS
  Treatment in a Dutch general hospital of a RAAA with an eEVAR procedure has a lower mortality in comparison to the open repair. Therefore, whenever possible the eEVAR is the preferred treatment method.
authors.affiliation: Department of Surgery, Amphia Hospital, Breda, The Netherlands. LvanderLaan@Amphia.nl
authors.forename: D E
authors.initials: DE
authors.lastname: Van Schaik
authors.forename: D E J G
authors.initials: DE
authors.lastname: Dolmans
authors.forename: G
authors.initials: G
authors.lastname: Ho
authors.forename: G P
authors.initials: GP
authors.lastname: Geenen
authors.forename: L
authors.initials: L
authors.lastname: Vos
authors.forename: J C
authors.initials: JC
authors.lastname: Van Der Waal
authors.forename: H G
authors.initials: HG
authors.lastname: De Groot
authors.forename: L
authors.initials: L
authors.lastname: Van Der Laan
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D001019:Aortic Rupture / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D001027:Aortography / Q000379:methods; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001803:Blood Transfusion; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality; D016009:Chi-Square Distribution; D057510:Endovascular Procedures / Q000009:adverse effects / Q000401:mortality; D005260:Female; D017052:Hospital Mortality; D006769:Hospitals, General; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D009426:Netherlands; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000628:therapy; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome