title: Mid-term outcomes following emergency endovascular aortic aneurysm repair for ruptured abdominal aortic aneurysms.
abstract: OBJECTIVE
  Emergency Endovascular Aortic Aneurysm Repair (eEVAR) is a rapidly evolving approach to ruptured Abdominal Aortic Aneurysms (rAAA). Yet longer-term outcomes following eEVAR remain unclear. This study compares mid-term outcomes of eEVAR and open rAAA.
  
  
  METHODS
  A prospective database for all patients undergoing eEVAR and open rAAA from January 2006 to April 2010 was analysed. Patients were offered eEVAR if anatomically suitable.
  
  
  RESULTS
  52 patients (45 male, median age 78 years (62-92 years), underwent eEVAR, 50 patients (44 male, median age = 71 (62-95 years) underwent open rAAA repair. In-hospital mortalities were 12% (6/52) for eEVAR, 32% (16/50) for open repair. There were five re-interventions (10%) in the eEVAR group. The peri-operative survival benefits of eEVAR over open rAAA repair were maintained at 1 and 2 years post-operatively with open repair demonstrating a two-fold increased risk of mortality (Hazard ratio 2.2, Fisher Exact test, 95% Confidence Interval (CI) 1.108-4.62, p = 0.0122). Overall survival was 81% at 1 year, 73% at 2 years for eEVAR, and 62% at 1 year and 52% at 2 years for open rAAA repair.
  
  
  CONCLUSIONS
  EEVAR is associated with excellent mid-term survival in this cohort. We would recommend eEVAR as the management of choice for rAAA in anatomically suitable patients where local facilities and expertise exist.
authors.affiliation: Cambridge Vascular Unit, Cambridge University Hospitals, NHS Foundation Trust, Cambridge, UK.
authors.forename: A
authors.initials: A
authors.lastname: Noorani
authors.forename: A
authors.initials: A
authors.lastname: Page
authors.forename: S R
authors.initials: SR
authors.lastname: Walsh
authors.forename: K
authors.initials: K
authors.lastname: Varty
authors.forename: P D
authors.initials: PD
authors.lastname: Hayes
authors.forename: J R
authors.initials: JR
authors.lastname: Boyle
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001019:Aortic Rupture / Q000601:surgery*; D057510:Endovascular Procedures / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome