World Journal of Surgery

, Volume 30, Issue 10, pp 1809–1814 | Cite as

Endovascular Techniques for the Treatment of Ruptured Abdominal Aortic Aneurysms: 7-year Intention-to-treat Results

  • Ilias Dalainas
  • Giovanni Nano
  • Paolo Bianchi
  • Silvia Stegher
  • Renato Casana
  • Giovanni Malacrida
  • Domenico G. Tealdi
Article

Abstract

Objectives

The purpose of this single-institution study was to describe our 7-year intention-to-treat results, obtained with the use of endovascular techniques for the treatment of ruptured abdominal aortic aneurysms (rAAA).

Patients and Methods

From October 1998 until March 2005, a total of 28 patients were admitted or transferred to our department with an rAAA. They were all treated according to a management protocol of intention-to-treat with endovascular techniques. Twenty of the patients received endovascular treatment and the remaining 8 underwent an open surgery procedure.

Results

The mortality rate of the endovascularly treated patients was 40% (8 in 20), whereas of the 8 surgical patients 3 survived (mortality = 62.5%). The overall mortality rate of the 28 patients admitted with an rAAA was 46.4% (13 of 28 patients).

Conclusions

In our experience the intension-to-treat protocol for rAAA offered acceptable results in terms of mortality rates. Multi-center studies are necessary to establish the role of endovascular treatment in patients with rAAA.

References

  1. 1.
    Calderwood R, Halka T, Haji-Michael P, et al. Ruptured abdominal aortic aneurysm. Is it possible to predict outcome? Int Angiol 2004;23:47PubMedGoogle Scholar
  2. 2.
    Heller JA, Weinberg A, Arons A, et al. Two decades of abdominal aortic aneurysm repair: have we made any progress? J Vasc Surg 2000;32:1091PubMedCrossRefGoogle Scholar
  3. 3.
    Heikkinen M, Selenius JP, Auvinen O. Ruptured abdominal aortic aneurysm in a well-defined geographic area. J Vasc Surg 2002;35:291CrossRefGoogle Scholar
  4. 4.
    Cassar K, Godden DJ, Duncan JL. Community mortality after ruptured abdominal aortic aneurysm is unrelated to the distance to the surgical center. Br J Surg 2001;88:1341PubMedCrossRefGoogle Scholar
  5. 5.
    Semmens JB, Norman PE, Lawrence-Brown MM, et al. Influence of gender on outcome from ruptured abdominal aortic aneurysm. Br J Surg 2000;87:191PubMedCrossRefGoogle Scholar
  6. 6.
    Choksy SA, Wilmink AB, Quick CR. Ruptured abdominal aortic aneurysm in the Huntingdon district: a 10-year experience. Ann R Coll Surg Engl 1999;81:27PubMedGoogle Scholar
  7. 7.
    Bengtsson H, Bergqvist D. Rupture abdominal aortic aneurysm: a population-based study. J Vasc Surg 1993;18:74PubMedCrossRefGoogle Scholar
  8. 8.
    Previti FW, Onopchenko A, Glick B. The ruptured abdominal aortic aneurysm in a community hospital. A 5-year study. Am Surg 1992;58:499PubMedGoogle Scholar
  9. 9.
    AbuRahma AF, Woodruff BA, Lucente FC, et al. Factors affecting survival of patients with ruptured abdominal aortic aneurysm in a West Virginia community. Surg Gynecol Obstet 1991;172:377PubMedGoogle Scholar
  10. 10.
    Peppelenbosch N, Yilmaz N, van Marrewijk C, et al. Emergency treatment of acute symptomatic or ruptured abdominal aortic aneurysm. Outcome of a prospective intent-to-treat by EVAR protocol. Eur J Vasc Endovas Surg 2003;26:303CrossRefGoogle Scholar
  11. 11.
    Gloviczki P, Pairolero PC, Mucha P Jr, et al. Ruptured abdominal aortic aneurysms: repair should not be denied. J Vasc Surg 1992;15:851–857PubMedCrossRefGoogle Scholar
  12. 12.
    Cronenwett JL, Rutherford RB. Decision Making in Vascular Surgery, Philadelphia, W. B. Saunders Company, 2001Google Scholar
  13. 13.
    Castelli P, Caronno R, Piffaretti G, et al. Ruptured aortic aneurysm: endovascular treatment. Abdom Imaging 2005;30:263PubMedCrossRefGoogle Scholar
  14. 14.
    Dalainas I, Nano G, Casana R, et al. Mid-term results after endovascular repair of abdominal aortic aneurysms: a four-year experience. Eur J Vasc Endovasc Surg 2004;27:319PubMedGoogle Scholar
  15. 15.
    Gerassimidis TS, Papazoglou KO, Kamparoudis AG, et al. Endovascular management of ruptured abdominal aortic aneurysms: 6-year experience from a Greek center. J Vasc Surg 2005;42:615–623PubMedCrossRefGoogle Scholar
  16. 16.
    Yilmaz N, Peppelenbosch N, Cuypers PW, et al. Emergency treatment of symptomatic or ruptured abdominal aortic aneurysms: the role of endovascular repair. J Endovasc Ther 2002;24:449–457CrossRefGoogle Scholar
  17. 17.
    van Sambeek MRHM, van Dijk LC, Hendriks JM, et al. Endovascular versus conventional open repair of acute abdominal aortic aneurysm: feasibility and preliminary results. J Endovasc Ther 2002;9:443–448PubMedCrossRefGoogle Scholar
  18. 18.
    Kapma MR, Verhoeven EL, Tielliu IF, et al. Endovascular treatment of acute abdominal aortic aneurysm with a bifurcated stent graft. Eur J Vasc Endovasc Surg 2005;29:510–515PubMedCrossRefGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2006

Authors and Affiliations

  • Ilias Dalainas
    • 1
    • 2
  • Giovanni Nano
    • 1
  • Paolo Bianchi
    • 1
  • Silvia Stegher
    • 1
  • Renato Casana
    • 1
  • Giovanni Malacrida
    • 1
  • Domenico G. Tealdi
    • 1
  1. 1.1st Unit of Vascular Surgery, Istituto Policlinico San Donato–School of Vascular SurgeryUniversity of MilanMilanItaly
  2. 2.MilanItaly

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