Emergency endovascular treatment of emergent or ruptured aortic aneurysms: A single centre experience

Abstract 

Objective

To report our experience with emergency endovascular repair (eEVAR) in patients with ruptured or acutely symptomatic AA.

Methods

From August 1998 to June 2004, 22 high-risk patients (21 men, median age 74 years, range 15–84 years) with ruptured or acutely symptomatic aneurysms underwent eEVAR using Talent endoprostheses. All procedures were performed in the operating theatre by a surgical/radiology team. Indications for repair, co-morbidities and outcomes were recorded with follow-up by US and CT scanning.

Results

Of 22 eEVARs, 13 patients had abdominal AA and nine patients had thoracic AA. Nineteen (86.4%) repairs were technically successful, there was one patient with a type I proximal endoleak treated conservatively and two patients died during their inpatient period (myocardial infarction and broncho-pneumonia). On follow-up of the 20 survivors (median 7 months, range 0–48 months), there were three further deaths, and two further endoleaks. The 1-year survival by life-table analysis is 75±9.8% and 13 patients are free from reintervention at last follow-up.

Conclusion

eEVAR had encouraging initial results in selected high-risk patients.

Keywords: Ruptured aneurysm, Acutely symptomatic aneurysm, Endovascular aortic aneurysm repair, Stent-graft