title: Endovascular repair versus open surgery in patients in the treatment of the ruptured of aneurysms abdominal.
abstract: BACKGROUND
  Rupture of abdominal aortic aneurysm is still a difficult challenge for the vascular surgeon due to the high perioperative mortality. The aim of our study is to describe the characteristics of the population as well as to compare morbidity and mortality in patients undergoing open surgery or endovascular repair in our center.
  
  
  METHODS
  Database with 82 rAAA between January 2002-December 2014, studying two cohorts, open surgery and endovascular repair. Epidemiologic, clinical, surgical techniques, perioperative mortality and complications are analyzed.
  
  
  RESULTS
  82 rAAA cases were operated (men: 80, women: 2). Mean age 72±9.6 years. 76.8% (63 cases) was performed by open surgery.
  
  
  BACKGROUND
  smokers 59, 7%, alcoholism 19.5%, DM 10.9%, AHT: 53.6%, dyslipidemia 30.5%. The most frequent clinical presentation was abdominal pain with lumbar irradiation: 50 cases (20.7% associating syncope). Overall hospital mortality was 58.5%. Hemodynamic shock prior to intervention was associated with increased mortality (p <.001). Anemia, leukocytosis, aneurysm size, sex and age did not show a statistically significant difference with respect to mortality (p>.05). The presence of iliac aneurysms was associated with increased mortality (p <.0045). Perioperative mortality in endovascular repair was 42%, and in open surgery was 63.5% (p>.05). Hospital stay was lower in the endovascular group (p=.3859).
  
  
  CONCLUSIONS
  Hemodynamic shock and the presence of concomitant iliac aneurysms have a statistically significant association with perioperative mortality in both groups. We found clinically significant differences in mortality, complications and hospital stay when comparing both groups with better results for EVAR, without statistically significant differences.
authors.affiliation: Hospital Universitario de León. Electronic address: glori_mry@hotmail.com.
authors.forename: Gloria María
authors.initials: GM
authors.lastname: Novo Martínez
authors.affiliation: Hospital Universitario de León.
authors.forename: Marta
authors.initials: M
authors.lastname: Ballesteros Pomar
authors.affiliation: Hospital Universitario de León.
authors.forename: Elena
authors.initials: E
authors.lastname: Menéndez Sánchez
authors.affiliation: Hospital Universitario de León.
authors.forename: Eliezer
authors.initials: E
authors.lastname: Santos Alcántara
authors.affiliation: Hospital Universitario de León.
authors.forename: Inés
authors.initials: I
authors.lastname: Rodríguez Fernández
authors.affiliation: Hospital Universitario de León.
authors.forename: Andrés Manuel
authors.initials: AM
authors.lastname: Zorita Calvo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000401:mortality / Q000601:surgery*; D001019:Aortic Rupture / Q000401:mortality / Q000601:surgery*; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D014656:Vascular Surgical Procedures
keywords: Aneurisma de aorta abdominal roto; Cirugía abierta; Endovascular repair; Hemodynamic shock; Mortalidad; Mortality; Open surgery; Reparación endovascular; Ruptured abdominal aortic aneurysm; Shock hemodinámico