Treatment of ruptured abdominal aortic aneurysm after endovascular abdominal aortic repair: A comparison with patients without prior treatment

Abstract

In terms of mortality, it would be logical to expect a protection from the endograft in patients with previous EVAR. A trend seems to confirm this assumption, but no statistical significance was found, which may be due to the small population size.

Treatment options for delayed AAA rupture following endovascular repair

“…Other considerable factors include the type of stent graft fixation (suprarenal versus infrarenal, and active with hooks/barbs vs passive with self-expanding stent only), as this too influences the sight of aortic clamping and the possible adjunctive need for visceral endarterectomy and/or revascularization with complete stent graft explant. 18,19 It is our fundamental belief that infrarenal aortic clamping with partial stent graft explant might be a significantly less morbid procedure when compared with supravisceral aortic clamp and complete stent graft explant, with possible visceral reconstructions, particularly in many of these high-risk aneurysm patients. 20 If the etiology of the aneurysm rupture is secondary to Type I, II, or III endoleak and can be determined by a preoperative CT scan, the surgeon may have some foresight into further options for subsequent revascularization.…”

Efficacy of endovascular management approach of ruptured abdominal aortic aneurysm

“…There is still some suggestive evidence that during the postoperative period (30 days), the results of the endovascular approach (Evar) ruptured AAA can be better than open repair of AAA. 32,33,35,[76][77][78][79] As a result, in cases where there are multiple risk factors and a poor prognosis with regard to the open technique, as well as a proper anatomy for the endovascular procedure, we suggest an attempt to EVAR, since the hospital service has experienced staff and appropriate equipment available.…”

Late Complications Following Aortic Aneurysm Repair

“…30-day mortality was 28.5 % in previously treated patients and 38.7% in primary ruptures. This was not a significant difference (Coppi et al, 2009). Others claim the opposite: more mortality after previous EVAR.…”