Mortality of ruptured abdominal aortic aneurysm treated with open or endovascular repair
Received 9 May 2008; accepted 15 July 2008. published online 02 October 2008.
Objectives
The study defined the selection criteria used for treatment of ruptured abdominal aortic aneurysms (RAAAs) and reviewed results during a 5-year period.
Methods
From 2002 on, our tertiary referral center adopted a protocol of selective use of endovascular repair for RAAAs. The study included all patients with a proven RAAA who were admitted to our hospital from 2002 to 2006. The primary outcome measure was surgical mortality.
Results
A total of 187 patients were admitted with an acute AAA, and an RAAA was confirmed 135 (72%) by computed tomography scanning or at laparotomy, and 125 (93%) were treated, 89 by open means and 36 by endovascular means. The overall mortality rate was 24% and the mortality rate was 13.9% for endovascular repair. Endovascular repair was consistently used more often in patients with favorable anatomy and in patients who were hemodynamically more stable. There were considerable differences in approach between the four consultant vascular surgeons. The overall evaluation and inclusion for endovascular treatment increased during the study period.
Conclusions
A strict protocol for admission, evaluation, and treatment of RAAA, with selective use of endovascular repair, resulted in low mortality rates in our center.
aDepartment of Surgery, University Medical Center Groningen, Groningen, The Netherlands
cDepartment of Epidemiology, University Medical Center Groningen, Groningen, The Netherlands
bDepartment of Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
Correspondence: Eric L. G. Verhoeven, MD, PhD, Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, Hanzeplein 1, PO Box 30,001, 9700 RB Groningen, The Netherlands
Competition of interest: Dr Verhoeven has received consulting fees and research grants from William Cook Europe and W. L. Gore and Associates.
ABSTRACT