Integration of endovascular therapy of ruptured abdominal and iliac aneurysms in the treatment algorithm: a single-center experience in a medium-volume vascular center

Vasc Endovascular Surg. 2014 Jul-Aug;48(5-6):412-20. doi: 10.1177/1538574414544383. Epub 2014 Jul 31.

Abstract

Purpose: To evaluate the influence of endovascular therapy of ruptured abdominal or iliac aneurysms on total mortality.

Materials and methods: We analyzed the mortality of 40 patients from 2005 to 2009, when only surgical treatment was available. These results were compared with the period 2010 to 2013, when endovascular aneurysm repair (EVAR) was assessed as the first option in selected patients.

Results: During 2005 to 2009, the mortality was 37.5%. From 2010 to 2013, 45 patients were treated with mortality 28.9%. Open repair was performed in 35 (77.8%) patients and EVAR in 10 (22.2%) patients. The 30-day and 1-year mortality rates of the EVAR group were 0% and 20%, respectively, and the total mortality rate was 30% during follow-up (median 11 months, range 1-42 months). The 30-day mortality in the surgical group remained unchanged, at 37.1%, and 1-year and total mortality rates were 45.7% and 51.4%, respectively.

Conclusion: Following integration in the treatment algorithm, EVAR decreased total mortality in our center by 8.6%.

Keywords: abdominal aortic aneurysm; endovascular treatment; iliac artery aneurysm; rupture; stent-graft.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Algorithms*
  • Aneurysm, Ruptured / diagnosis
  • Aneurysm, Ruptured / mortality
  • Aneurysm, Ruptured / surgery*
  • Aortic Aneurysm, Abdominal / diagnosis
  • Aortic Aneurysm, Abdominal / mortality
  • Aortic Aneurysm, Abdominal / surgery*
  • Aortic Rupture / diagnosis
  • Aortic Rupture / mortality
  • Aortic Rupture / surgery*
  • Aortography / methods
  • Blood Vessel Prosthesis
  • Blood Vessel Prosthesis Implantation* / adverse effects
  • Blood Vessel Prosthesis Implantation* / instrumentation
  • Blood Vessel Prosthesis Implantation* / mortality
  • Critical Pathways
  • Czech Republic
  • Delivery of Health Care, Integrated*
  • Endovascular Procedures* / adverse effects
  • Endovascular Procedures* / instrumentation
  • Endovascular Procedures* / mortality
  • Feasibility Studies
  • Female
  • Hospitals, University*
  • Humans
  • Iliac Aneurysm / diagnosis
  • Iliac Aneurysm / mortality
  • Iliac Aneurysm / surgery*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Stents
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome