title: Integration of endovascular therapy of ruptured abdominal and iliac aneurysms in the treatment algorithm: a single-center experience in a medium-volume vascular center.
abstract: OBJECTIVE
  To evaluate the influence of endovascular therapy of ruptured abdominal or iliac aneurysms on total mortality.
  
  
  METHODS
  We analyzed the mortality of 40 patients from 2005 to 2009, when only surgical treatment was available. These results were compared with the period 2010 to 2013, when endovascular aneurysm repair (EVAR) was assessed as the first option in selected patients.
  
  
  RESULTS
  During 2005 to 2009, the mortality was 37.5%. From 2010 to 2013, 45 patients were treated with mortality 28.9%. Open repair was performed in 35 (77.8%) patients and EVAR in 10 (22.2%) patients. The 30-day and 1-year mortality rates of the EVAR group were 0% and 20%, respectively, and the total mortality rate was 30% during follow-up (median 11 months, range 1-42 months). The 30-day mortality in the surgical group remained unchanged, at 37.1%, and 1-year and total mortality rates were 45.7% and 51.4%, respectively.
  
  
  CONCLUSIONS
  Following integration in the treatment algorithm, EVAR decreased total mortality in our center by 8.6%.
authors.affiliation: Department of Radiology, Faculty of Medicine at Charles University and University Hospital, Hradec Kralove, Czech Republic janraupach@seznam.cz.
authors.forename: Jan
authors.initials: J
authors.lastname: Raupach
authors.affiliation: Department of Surgery, Faculty of Medicine at Charles University and University Hospital, Hradec Kralove, Czech Republic.
authors.forename: Daniel
authors.initials: D
authors.lastname: Dobes
authors.affiliation: Department of Radiology, Faculty of Medicine at Charles University and University Hospital, Hradec Kralove, Czech Republic.
authors.forename: Miroslav
authors.initials: M
authors.lastname: Lojik
authors.affiliation: Department of Radiology, Faculty of Medicine at Charles University and University Hospital, Hradec Kralove, Czech Republic.
authors.forename: Vendelin
authors.initials: V
authors.lastname: Chovanec
authors.affiliation: Department of Surgery, Faculty of Medicine at Charles University and University Hospital, Hradec Kralove, Czech Republic.
authors.forename: Alexander
authors.initials: A
authors.lastname: Ferko
authors.affiliation: Department of Surgery, Faculty of Medicine at Charles University and University Hospital, Hradec Kralove, Czech Republic.
authors.forename: Igor
authors.initials: I
authors.lastname: Gunka
authors.affiliation: Department of Medicine, Faculty of Medicine at Charles University and University Hospital, Hradec Kralove, Czech Republic.
authors.forename: Radovan
authors.initials: R
authors.lastname: Maly
authors.affiliation: Department of Cardiac Surgery, Faculty of Medicine at Charles University and University Hospital, Hradec Kralove, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Vojacek
authors.affiliation: Department of Surgery, Faculty of Medicine at Charles University and University Hospital, Hradec Kralove, Czech Republic.
authors.forename: Eduard
authors.initials: E
authors.lastname: Havel
authors.affiliation: Department of Surgery, Faculty of Medicine at Charles University and University Hospital, Hradec Kralove, Czech Republic.
authors.forename: Michal
authors.initials: M
authors.lastname: Lesko
authors.affiliation: Department of Radiology, Faculty of Medicine at Charles University and University Hospital, Hradec Kralove, Czech Republic.
authors.forename: Ondrej
authors.initials: O
authors.lastname: Renc
authors.affiliation: Department of Radiology, Faculty of Medicine at Charles University and University Hospital, Hradec Kralove, Czech Republic.
authors.forename: Petr
authors.initials: P
authors.lastname: Hoffmann
authors.affiliation: Department of Radiology, Faculty of Medicine at Charles University and University Hospital, Hradec Kralove, Czech Republic.
authors.forename: Pavel
authors.initials: P
authors.lastname: Ryska
authors.affiliation: Department of Radiology, Faculty of Medicine at Charles University and University Hospital, Hradec Kralove, Czech Republic.
authors.forename: Antonin
authors.initials: A
authors.lastname: Krajina
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D017542:Aneurysm, Ruptured / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D001019:Aortic Rupture / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D019091:Critical Pathways; D018153:Czech Republic; D019033:Delivery of Health Care, Integrated; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D005240:Feasibility Studies; D005260:Female; D006785:Hospitals, University; D006801:Humans; D017543:Iliac Aneurysm / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: abdominal aortic aneurysm; endovascular treatment; iliac artery aneurysm; rupture; stent-graft