Five-year survival following endovascular repair of ruptured abdominal aortic aneurysms is improving

Varkevisser, Rens R.B.; Swerdlow, Nicholas J.; Guerre, Livia E.V.M. de; Dansey, Kirsten; Stangenberg, Lars; Giles, Kristina A.; Verhagen, Hence J.M.; Schermerhorn, Marc L.

doi:10.1016/j.jvs.2019.10.074

Cited by 40 publications

(22 citation statements)

References 29 publications

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“…These results are similar to previously reported Vascular Quality Initiative, National Surgical Quality Improvement Program, and multicenter studies demonstrating improved shortand mid-term outcomes with EVAR compared with OAR, contributing further to the increasing body of data supporting an EVAR-first approach for patients with suitable anatomy. 5,6,[9][10][11]14,23,24 More importantly, our results have confirmed the validity of the HRS in predicting for 30-day mortality in a prospective consecutive series of modern patients with rAAAs. These results are similar to our previously reported results and have confirmed that the presence of four preoperative factors is associated with a very high risk of 30-day death after repair.…”

Section: Discussionsupporting

confidence: 79%

“…[1][2][3][4] Although centralization of care and the adoption of endovascular aneurysm repair (EVAR) treatment strategies have improved survival after rAAA repair, the treatment of rAAAs is resource intensive, and mortality has remained high. [5][6][7][8][9][10][11][12][13][14][15][16] The existence of an accurate preoperative risk stratification tool, which could predict who might benefit from surgery, would, therefore, not only help guide clinicians and patients in decision-making, but would also allow for the appropriate allocation of healthcare resources.…”

Section: Discussionmentioning

confidence: 99%

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Preoperative risk score accuracy confirmed in a modern ruptured abdominal aortic aneurysm experience

Hemingway

French

Caps

et al. 2021

Journal of Vascular Surgery

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Preoperative risk score accuracy confirmed in a modern ruptured abdominal aortic aneurysm experience

Hemingway

French

Caps

et al. 2021

Journal of Vascular Surgery

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“…As with elective AAA repairs, use of EVAR for rAAA repair has increased massively in the past two decades [ 251 , 252 ]. Analyses of earlier versus later cohorts show that outcomes have improved in recent years for both EVAR and OSR [ 310 , 311 ]. High mortality rates of unsuccessful EVAR for rAAA suggest that anatomical suitability and not hemodynamic condition should be the pivotal factor in choosing the surgical method for rAAA repair [ 251 , 312 , 313 ].…”

Section: Diagnosis and Managementmentioning

confidence: 99%

AAA Revisited: A Comprehensive Review of Risk Factors, Management, and Hallmarks of Pathogenesis

et al. 2022

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Despite declining incidence and mortality rates in many countries, the abdominal aortic aneurysm (AAA) continues to represent a life-threatening cardiovascular condition with an overall prevalence of about 2–3% in the industrialized world. While the risk of AAA development is considerably higher for men of advanced age with a history of smoking, screening programs serve to detect the often asymptomatic condition and prevent aortic rupture with an associated death rate of up to 80%. This review summarizes the current knowledge on identified risk factors, the multifactorial process of pathogenesis, as well as the latest advances in medical treatment and surgical repair to provide a perspective for AAA management.

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“…Recently, it has been reported that EVAR has better outcomes. [1][2][3][4][5] However, open repair have more preoperative rsks. This difference was reflected in the mortality and morbidity associated with EVAR and open repair procedures.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, EVAR has improved the surgical outcomes of rAAA. [1][2][3][4][5] Moreover, EVAR confers not only survival advantage but is also cost effective. 6) EVAR has been performed by radiologists at our hospital.…”

Section: Introductionmentioning

confidence: 99%

Treatment Strategies for Improving the Surgical Outcomes of Ruptured Abdominal Aortic Aneurysm: Single-Center Experience in Japan

Maze

Tokui

Murakami

et al. 2022

Annals of Vascular Diseases

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Objective:We aimed to examine the surgical outcomes of ruptured abdominal aortic aneurysm cases at our hospital and considered strategies for improvement. Material and Methods: We examined the preoperative characteristics of hospital mortality, postoperative complications, and long-term outcomes of 91 surgical cases of ruptured abdominal aortic aneurysm performed between January 2009 and December 2020 at our hospital. Results: Of the 91 cases, 24 died at the hospital (mortality, 26.3%). Mortality was mostly due to hemorrhage/disseminated intravascular coagulation and intestinal necrosis. Ten patients required preoperative aortic clamp by thoracotomy or insertion of intra-aortic balloon occlusion, and eight of them died. Ten patients required open abdominal management due to abdominal compartment syndrome, and five of them died. There was no significant difference between the two groups in terms of the long-term results of the open repair and abdominal endovascular aneurysm repair (EVAR). Conclusion:To improve the surgical outcomes of ruptured abdominal aortic aneurysms, it is necessary to start surgery immediately. Therefore, the choice of surgical method (open surgery or EVAR) should be based on the resources and discretion of the hospital. To prevent postoperative intestinal necrosis, risk factors for acute compartment syndrome should be considered, and open abdominal management should be introduced.

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Five-year survival following endovascular repair of ruptured abdominal aortic aneurysms is improving

Cited by 40 publications

References 29 publications

Preoperative risk score accuracy confirmed in a modern ruptured abdominal aortic aneurysm experience

Preoperative risk score accuracy confirmed in a modern ruptured abdominal aortic aneurysm experience

AAA Revisited: A Comprehensive Review of Risk Factors, Management, and Hallmarks of Pathogenesis

Treatment Strategies for Improving the Surgical Outcomes of Ruptured Abdominal Aortic Aneurysm: Single-Center Experience in Japan

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