Document Detail

Improved survival after abdominal aortic aneurysm rupture by offering both open and endovascular repair.
MedLine Citation:
PMID:  18559746     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: In the treatment of ruptured abdominal aortic aneurysm (rAAA), the results of open graft replacement (OGR) have remained constant but discouraging for the last 4 decades. Provided suitable anatomy, elective endovascular abdominal aortic aneurysm repair (EVAR) is less invasive and leads to improved perioperative mortality. Thus, it is reasonable to assume that endovascular treatment should improve the results of rAAA therapy. OBJECTIVE: To determine whether the use of both endovascular and open repair of rAAA leads to improved results. DESIGN: A single-center, retrospective analysis of 89 patients suffering from rAAA treated either by EVAR or OGR. PATIENTS: From October 1999 until July 2006, a consecutive series of patients with rAAA were analyzed. Time was divided into 2 periods of 41 months. During the first period, 42 patients were treated by OGR exclusively. Period 2 started with the availability of an EVAR protocol to treat rAAA; 31 patients received open repair while 16 patients underwent EVAR. MAIN OUTCOME MEASURES: Kaplan-Meier survival estimates were calculated and compared. RESULTS: Survival estimates showed a statistically significant reduction in overall postoperative mortality following the introduction of EVAR (P < .03). The 90-day overall mortality rate was reduced from 54.8% to 27.7% during the second period (P < .01). Survival of patients older than 75.5 years was especially improved (75% vs 28.6%; P < .01). There was a parallel pattern of significant reduction of the mortality rate after OGR to 29% (P < .03). CONCLUSION: Offering both EVAR and OGR to patients with rAAA leads to significant improvements in postoperative survival.
Andreas Wibmer; Maria Schoder; Klaus S Wolff; Alexander M Prusa; Maryana Sahal; Johannes Lammer; Ihor Huk; Peter Polterauer; Georg Kretschmer; Harald Teufelsbauer
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Archives of surgery (Chicago, Ill. : 1960)     Volume:  143     ISSN:  1538-3644     ISO Abbreviation:  Arch Surg     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-06-18     Completed Date:  2008-07-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9716528     Medline TA:  Arch Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  544-9; discussion 550     Citation Subset:  AIM; IM    
Department of Vascular Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
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MeSH Terms
Aged, 80 and over
Aortic Aneurysm, Abdominal / diagnosis,  mortality*,  surgery
Aortic Rupture / diagnosis,  mortality*,  surgery
Austria / epidemiology
Follow-Up Studies
Middle Aged
Retrospective Studies
Survival Rate / trends
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Vascular Surgical Procedures / methods*

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