Ruptured inflammatory abdominal aortic aneurysm: insights in clinical management and outcome
| Autor: | J. A. Murie, Andrew L. Tambyraja, Roderick T.A. Chalmers |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Male
medicine.medical_specialty Aortic Rupture medicine.medical_treatment Aortic Diseases Aortoenteric fistula macromolecular substances Cohort Studies Aortic aneurysm Postoperative Complications Aneurysm Hematoma medicine Humans Hospital Mortality cardiovascular diseases Renal replacement therapy Aortic rupture Aged Retrospective Studies Inflammation Vascular Fistula business.industry Vascular disease Incidence Length of Stay medicine.disease Surgery Treatment Outcome cardiovascular system Female Cardiology and Cardiovascular Medicine business Aortic Aneurysm Abdominal Abdominal surgery |
| Zdroj: | Journal of Vascular Surgery. 39:400-403 |
| ISSN: | 0741-5214 |
| Popis: | Background Ruptured inflammatory abdominal aortic aneurysm (AAA) is relatively rare, and little has been written on the outcome of operative treatment. Methods Patients undergoing attempted repair of ruptured inflammatory AAA between 1995 and 2001 were included in a retrospective case-cohort study. Demographic, clinical, and operative factors were analyzed, together with in-hospital morbidity, in-hospital mortality, and duration of postoperative hospital stay. Results Of 297 patients who underwent attempted operative repair of ruptured AAA, 24 (8%) had an inflammatory aneurysm. Twenty-two patients were men, and two were women; median age was 69 years (range, 51-85 years). Operative findings revealed a contained hematoma in 16 patients (70%), free rupture in 3 patients (13%), aortocaval fistula in 4 patients (17%), and aortoenteric fistula in 1 patient (4%). Of 273 noninflammatory ruptured AAAs, only 2 AAA (1%) were associated with primary aortic fistula. Ten patients (42%) with inflammatory AAA died in hospital, compared with 117 of 273 patients (43%) without inflammation. Median postoperative stay was 10 days (range, 0-35 days). Of the 14 patients with inflammatory lesions who survived, 11 had postoperative complications; 4 patients had acute renal failure, three of whom required temporary renal replacement therapy. Conclusions Ruptured inflammatory AAA is associated with a higher incidence of aortic fistula than is ruptured noninflammatory AAA. Repair of ruptured inflammatory AAA is not associated with increased operative mortality compared with repair of ruptured noninflammatory AAA. |
| Databáze: | OpenAIRE |
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