Document Detail


Suitability of ruptured AAA for endovascular repair.
MedLine Citation:
PMID:  15615554     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To determine the anatomical suitability and the range of endografts required to undertake an endovascular repair (EVR) program for ruptured abdominal aortic aneurysms. METHODS: The morphology of ruptured and nonruptured AAAs were compared by retrospective review of computed tomographic scans from 51 patients (47 men; mean age 76 years, range 55-90) with ruptured AAAs and 50 patients (37 men; mean age 74 years, range 57-75) with nonruptured AAAs. Three experienced clinicians reviewed the scans for EVR suitability based on a generic trimodular endograft with suprarenal fixation. Endograft oversizing was assumed to be 10% to 20%. RESULTS: Interobserver agreement was high, with a mean kappa of 0.78 (range 0.75-0.83, p<0.001). In all, 41% of ruptured and 68% of nonruptured AAAs were suitable for EVR (p=0.009). Ruptured AAAs had shorter mean neck lengths (17+/-12 versus 22+/-11 mm, p=0.031) and larger mean aneurysm diameters (75+/-15 versus 63+/-9 mm, p>0.001). Neck length and neck diameter were significantly correlated for ruptured AAAs (r=-0.34, p=0.018). The main contraindication to EVR was hostile neck morphology. A range of endografts with aortic components from 24 to 32 mm and iliac components from 12 to 22 mm would be required to stent 41% of ruptured AAAs. CONCLUSIONS: Ruptured AAAs are less suitable for EVR due to differing neck morphology. An EVR program for ruptured AAA requires an inventory of endografts with appropriate aortic and iliac components.
Authors:
W Richard W Wilson; Guy Fishwick; Sir Peter R F Bell; Matthew M Thompson
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists     Volume:  11     ISSN:  1526-6028     ISO Abbreviation:  J. Endovasc. Ther.     Publication Date:  2004 Dec 
Date Detail:
Created Date:  2004-12-23     Completed Date:  2005-05-10     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100896915     Medline TA:  J Endovasc Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  635-40     Citation Subset:  IM    
Affiliation:
Department of Surgery, University Hospitals of Leicester, UK.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Aneurysm, Ruptured / radiography,  surgery*
Angiography / methods
Aortic Aneurysm, Abdominal / radiography,  surgery*
Blood Vessel Prosthesis*
Blood Vessel Prosthesis Implantation / methods*
Cohort Studies
Female
Follow-Up Studies
Humans
Male
Middle Aged
Observer Variation
Patient Selection
Probability
Retrospective Studies
Severity of Illness Index
Surgical Procedures, Minimally Invasive / methods
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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