A single-centre experience of the treatment of ruptured abdominal aortic aneurysms: clinical and anatomic characteristics of open versus endovascular repair.
OBJECTIVE
The treatment of ruptured abdominal aortic aneurysms is a constant challenge for vascular surgeons and can be achieved either by endovascular repair or by an open surgical technique. Endovascular repair presents a higher 30-day survival rate. The aim of this study was to compare the clinical and anatomical characteristics and the outcomes of these two treatment techniques.


METHODS
Our study sample comprised patients who presented at the emergency department of a General Regional Hospital with rupture of an abdominal aortic aneurysm between January 2003 and December 2008. Of the 43 patients who were treated, 23 underwent open surgical repair and 20 underwent endovascular repair.


RESULTS
Comorbidities, age, clinical presentation and anatomical characteristics didn't present statistically significant differences in the two groups. Patients in the endovascular repair group were transfused with less units of blood and fresh frozen plasma (P=0.001) and had shorter stay in the intensive care unit (P=0.042). The 30-day mortality rate was 43% for open surgical repair and 35% for endovascular treatment (P=0.627), while the overall in-hospital mortality rate was 61% and 50% (P=0.474), respectively.


CONCLUSIONS
When certain anatomical characteristics are present and the hemodynamic condition of the patient allows it, endovascular treatment appears to be associated with better survival rates, both 30-day and overall.
First Surgical Department, General Regional Hospital George Papanikolaou, Thessaloniki, Greece. telonakos@hotmail.com
O
O
Ioannidis
G
G
Trellopoulos
G
G
Tamouridis
K
K
Konstantinidis
A
A
Megalopoulos
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D001019:Aortic Rupture / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; 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; D006439:Hemodynamics; D017052:Hospital Mortality; D006769:Hospitals, General; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011044:Poland; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome