| Suitability of ruptured AAA for endovascular repair. | |
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MedLine Citation:
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PMID: 15615554 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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W Richard W Wilson; Guy Fishwick; Sir Peter R F Bell; Matthew M Thompson |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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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:
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Created Date: 2004-12-23 Completed Date: 2005-05-10 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 100896915 Medline TA: J Endovasc Ther Country: United States |
Other Details:
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Languages: eng Pagination: 635-40 Citation Subset: IM |
Affiliation:
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Department of Surgery, University Hospitals of Leicester, UK. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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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