Establishing a protocol for endovascular treatment of ruptured abdominal aortic aneurysms: Outcomes of a prospective analysis

Abstract

The early results show that emergent endovascular treatment of hemodynamically stable and unstable patients is associated with a limited mortality of 18% once a standardized protocol is established. There is an increased recognition of emerging complications with an endovascular approach, and a synchrony of disciplines must be developed to initiate a successful program for endovascular treatment of r-AAAs.

Comparison of Open and Endovascular Repair of Ruptured Abdominal Aortic Aneurysms From the ACS-NSQIP 2005–07

“…The 24% EVAR mortality compares well to the 18% mortality rate reported by Mehta et al 2 Considering that the NSQIP includes a broad mix of community and academic medical centers, this result is impressive. As NSQIP is a quality improvement tool, howev-¤ ¤ er, most participating institutions likely represent high volume centers with an interest in improving their own outcomes.…”

“…Other institutional studies have reported mortality rates of 8% to 40%, but the number of patients within institutional studies, however, is still quite small. [2][3][4][5][6][7][8] Two recent meta-analyses reported pooled outcomes on EVAR for RAAA procedures. Rayt et al 12 found a mortality of 24% for 982 patients, while Azizzadeh et al 13 reported a mortality of 30% in 531 patients.…”

“…1 With emerging data from centers of excellence and community hospitals, it is apparent that EVAR for RAAA has shown a steady increase. [2][3][4][5][6][7][8] Comparison of this method of repair to its traditional open repair counterpart is difficult, however, as preoperative differences in hemodynamic stability are likely to play a large role in the decision for one type of repair over the other.…”

“…[2][3][4][5] Describing the results from one such program, Mehta et al 2 were able to show an 18% mortality rate following EVAR with a 95% success rate for the procedure, which compares favorably to prior repairs in which mortality for RAAA has hovered at 40% to 50% for the past 4 decades. 9 Moreover, this and other small institutional studies may not be representative of the population at large.…”

Endovascular treatment of acute rupture of abdominal aortic aneurysm

“…[14]. После этого методика эндоваскуляр-ного протезирования при разрыве АБА стала применяться во многих центрах [6,8,[11][12][13].…”