Document Detail

The utility of commercially available endografts in the treatment of contained ruptured abdominal aortic aneurysm with hemodynamic stability.
MedLine Citation:
PMID:  15218476     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Food and Drug Administration-approved endografts are suitable for the elective repair of abdominal aortic aneurysms (AAAs) with favorable aneurysm anatomy. Our aim is to illustrate the feasibility and versatility of commercially available endografts for emergency AAA repair in hemodynamically stable AAA rupture.
METHODS: From June 2001 to July 2002, five patients presented with severe abdominal pain and were diagnosed with contained rupture of an infrarenal AAA. In all cases, patients were deemed unfit to withstand conventional open repair by both the referring outside medical center as well as our center's team. All patients were hemodynamically stable on arrival at our medical center. Measurement and selection of endovascular devices were based on computed tomography (CT) scans performed emergently at the outside referring center. The required emergently procured endografts were obtained within 2 to 4.5 hours (mean, 3.1 hours) of presentation. Complex anatomy at the proximal and distal fixation zones or difficult access was present in every case.
RESULTS: All patients survived endograft repair and had successful exclusion of their aneurysm sac on the basis of intraoperative arteriography and postoperative CT surveillance. All were discharged to home at baseline function within a mean of 6.8 days (range, 2-13 days). There were no deaths. There was one postoperative pulmonary embolism, one myocardial infarct, and one type 2 endoleak. Mean operative time and blood loss were 4.67 hours and 217 mL, respectively. At a mean follow-up of 18 months, CT scans showed stable or shrinking aneurysm sacs.
CONCLUSIONS: In patients with contained ruptured AAAs who present with hemodynamic stability and comorbidities that preclude open surgery, commercially available endografts are a versatile treatment option even in the face of complicated aneurysm anatomy.
Joseph V Lombardi; Ronald M Fairman; Michael A Golden; Jeffrey P Carpenter; Marc Mitchell; Clyde Barker; Amy McBride; Omaida C Velazquez
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  40     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2004 Jul 
Date Detail:
Created Date:  2004-06-25     Completed Date:  2004-07-29     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  154-60     Citation Subset:  IM    
Division of Vascular Surgery, Jefferson Medical College, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
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MeSH Terms
Aortic Aneurysm, Abdominal / physiopathology,  radiography,  surgery*
Aortic Rupture / physiopathology,  radiography,  surgery*
Blood Vessel Prosthesis*
Blood Vessel Prosthesis Implantation / instrumentation,  methods*
Feasibility Studies
Tomography, X-Ray Computed

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

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