Endovascular Repair of Ruptured Abdominal Aortic Aneurysms: Experience in a Community Hospital

Abstract

The endovascular technique has been recently used as an alternative procedure for selected patients with ruptured abdominal aortic aneurysm (RAAA) as a result of the potential for decreasing morbidity, mortality, and recovery time. We examined our institution's results with endovascular repair of RAAA. Between July 2005 and April 2006, four patients underwent endovascular repair of infrarenal RAAA. We performed a retrospective analysis of our comorbidities, operation time, length of intensive care unit and hospital stay, morbidity and mortality, blood transfusions, and secondary interventions on these patients at our institution. The median age was 73.2 years (range, 66–82 years); 75 per cent were male and 25 per cent were female. Mean operating time was 90 minutes. We had no operative or postoperative mortalities. Five complications occurred in three patients. These included acute renal failure, common femoral artery intimal dissection, graft thrombosis of the iliac limb, ischemic colitis, and chronic obstructive pulmonary disease exacerbation. Endovascular repair of RAAA by an endovascular team is feasible in the community hospital setting. Our limited number of patients in this study does not allow us to compare it directly with results from the standard open procedure. A larger, multi-center study may eventually show this method to be helpful in patients who require repair of RAAA.

Endovascular Repair of Ruptured Abdominal Aortic Aneurysms in a Rural Center Is Both Feasible and Associated with Reduced Blood Product Requirements

“…Similar comments have been made in publications from other small centers. 7 To put our aneurysm activity into perspective, over the same time period, 140 patients underwent elective infrarenal AAA repair, 31 using an endovascular technique. This reflects our initially conservative use of this technology.…”