Ruptured abdominal aortic aneurysm: Is endovascular aneurysm repair the answer for everybody?
Treatment paradigms for elective repair of asymptomatic abdominal aortic aneurysms (AAA) have evolved during the past 2 decades, with endovascular aneurysm repair as the preferred treatment modality. The patient care strategy for emergent treatment for ruptured AAA is not as straightforward, due in part to surgeon expertise and stent-graft availability at the institution. Although most reports have extrapolated elective endovascular aneurysm repair feasibility data to the ruptured AAA patient and the aneurysm anatomy, these expectations should be interpreted with caution. In the absence of level I evidence, and lack of adequate local hospital resources, endovascular aneurysm repair-first policy might not be feasible for all the patients who present with ruptured AAA.
Division of Vascular Surgery, Penn State Heart and Vascular Institute, Department of Surgery, Pennsylvania State University College of Medicine, Penn State Milton S. Hershey Medical Center, 500 University Drive, Mail Code H053, Room C4632, Hershey, PA 17033. Electronic address: faziz@hmc.psu.edu.
Faisal
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Aziz
D017544:Aortic Aneurysm, Abdominal / Q000401:mortality / Q000601:surgery*; D001019:Aortic Rupture / Q000401:mortality / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000191:economics / Q000379:methods*; D002985:Clinical Protocols; D003362:Cost-Benefit Analysis; D057510:Endovascular Procedures / Q000191:economics; D006801:Humans; D011788:Quality of Life; D015607:Stents; D016896:Treatment Outcome