Long-term outcomes following endovascular aneurysm repair for ruptured abdominal aortic aneurysms

Guéroult, Aurélien M., Khan, Farhaan A., Stather, Philip W. ORCID: https://orcid.org/0000-0002-3585-6728, Harrison, Seamus C. and Boyle, Jonathan R. (2020) Long-term outcomes following endovascular aneurysm repair for ruptured abdominal aortic aneurysms. Journal of Endovascular Therapy, 27 (3). pp. 428-435. ISSN 1526-6028

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Purpose: To investigate the long-term outcomes of endovascular aneurysm repair (EVAR) for ruptured abdominal aortic aneurysm (rAAA) from a single center over an 11-year period. Materials and Methods: A retrospective analysis was conducted of 121 patients (median age 78 years; 100 men) with rAAA who underwent emergency EVAR at a single tertiary vascular center from January 2006 to December 2016. The study included only ruptures confirmed by evidence of hematoma on preoperative computed tomography; both iliac and aortic aneurysm ruptures were eligible. The primary outcome measures included mortality and reintervention rates. Kaplan-Meier estimates of survival and freedom from reintervention are reported with the 95% confidence interval (CI). Results: In-hospital and 30-day mortality rates for emergency EVAR were 16.5%; 90-day mortality was 24.0%. The mortality estimates were 27.3% (95% CI 20% to 36%) at 1 year and 61.7% (95% CI 51% to 72%) at 5 years. In the observation period to 2017, 63 reinterventions were performed on 37 patients (30.6%). Median time to the first reintervention was 3.2 years. Freedom from reintervention in surviving patients at 1 year was 86% (95% CI 72% to 94%) and 51% (95% CI 26% to 71%) at 5 years. Four patients (3.3%) had a secondary sac rupture over the study period. Conclusion: Emergency EVAR for ruptured AAA can be performed with acceptable short-term outcomes; however, long-term surveillance is necessary, and reintervention is common.

Item Type: Article
Uncontrolled Keywords: abdominal aortic aneurysm,aortic rupture,complications,emergency procedure,endograft,endoleak,endovascular aneurysm repair,mortality,reintervention,stent-graft,surgery,radiology nuclear medicine and imaging,cardiology and cardiovascular medicine ,/dk/atira/pure/subjectarea/asjc/2700/2746
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
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Depositing User: LivePure Connector
Date Deposited: 03 May 2023 16:30
Last Modified: 09 May 2023 08:30
URI: https://ueaeprints.uea.ac.uk/id/eprint/91987
DOI: 10.1177/1526602820919901

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