Long-term Outcomes Following Endovascular Aneurysm Repair for Ruptured Abdominal Aortic Aneurysms.

Autor:	Guéroult AM; Cambridge Vascular Unit, Cambridge University Hospitals NHS Trust, Addenbrooke's Hospital, Cambridge, UK., Khan FA; Cambridge Vascular Unit, Cambridge University Hospitals NHS Trust, Addenbrooke's Hospital, Cambridge, UK., Stather PW; Cambridge Vascular Unit, Cambridge University Hospitals NHS Trust, Addenbrooke's Hospital, Cambridge, UK., Harrison SC; Cambridge Vascular Unit, Cambridge University Hospitals NHS Trust, Addenbrooke's Hospital, Cambridge, UK., Boyle JR; Cambridge Vascular Unit, Cambridge University Hospitals NHS Trust, Addenbrooke's Hospital, Cambridge, UK.
Jazyk:	angličtina
Zdroj:	Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists [J Endovasc Ther] 2020 Jun; Vol. 27 (3), pp. 428-435.
DOI:	10.1177/1526602820919901
Abstrakt:	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.
Databáze:	MEDLINE
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