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Rupture of Abdominal Aortic Aneurysm in Patients with and without Antecedent Endovascular Repair.
Ann Vasc Surg. 2017 Feb; 39:99-104.AV

Abstract

BACKGROUND

Reported results of ruptured abdominal aortic aneurysm (rAAA) in patients with antecedent endovascular aneurysm repair (EVAR) to those presenting with de novo rupture show a similar or slightly improved outcome. The aim of this study was to compare differences in the presentation and outcomes of rAAA with and without prior EVAR.

METHODS

A retrospective review of 121 patients with rAAA, ruptured identified 2 groups. Group A included 17 patients (rAAA n = 17) with antecedent EVAR and group B consisted of 104 patients (rAAA n = 104) with de novo ruptures, from January 2001 to March 2015 in 3 teaching hospitals. Patient characteristics and perioperative variables were compared; Fisher's exact test was used for categorical variables. For continuous variables, Student's t-test and Mann-Whitney U test were used.

RESULTS

Both groups were similar in age, gender, the incidence of hypertension, coronary artery disease, diabetes mellitus, chronic obstructive pulmonary disease, and nicotine abuse. Mean time of presentation from EVAR to rupture in group A was 42 ± 22 months. Mean preoperative transverse or anteroposterior diameter of AAA was 6.6 cm in group A and 7.1 cm in group B. Three patients of 17 (17.6%) in group A were hemodynamically unstable as compared to 47 of 104 patients (45.1%) in group B (P = 0.03). Mean red blood cells, fresh frozen plasma, and platelet transfusion were similar in both groups. Thirty-day mortality was 8 of 17 (44.7%) in group A and 44 of 104 (42.3%) in group B (P = 1.0). Postoperative complications were also similar in both groups except the incidence of postoperative respiratory failure was higher in group B (38%) as compared with 11.1% in group A (P = 0.001).

CONCLUSIONS

Patients presenting with rAAA with antecedent EVAR are hemodynamically more stable as compared with patients with de novo rupture of AAA. Postoperative respiratory failure is more common in patients with de novo rupture. rAAA carry high mortality with and without prior EVAR.

Authors+Show Affiliations

Henry Ford-Macomb Hospital, Clinton Township, MI.William Beaumont Hospital, Royal Oak, MI.William Beaumont Hospital, Royal Oak, MI.Henry Ford-Macomb Hospital, Clinton Township, MI; St. John Macomb Hospital, Warren, MI.William Beaumont Hospital, Royal Oak, MI.William Beaumont Hospital, Royal Oak, MI.Henry Ford-Macomb Hospital, Clinton Township, MI; St. John Macomb Hospital, Warren, MI.William Beaumont Hospital, Royal Oak, MI.Henry Ford-Macomb Hospital, Clinton Township, MI; St. John Macomb Hospital, Warren, MI. Electronic address: sshans@comcast.net.

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study

Language

eng

PubMed ID

27522971

Citation

Catanescu, Irina, et al. "Rupture of Abdominal Aortic Aneurysm in Patients With and Without Antecedent Endovascular Repair." Annals of Vascular Surgery, vol. 39, 2017, pp. 99-104.
Catanescu I, Long G, Bove P, et al. Rupture of Abdominal Aortic Aneurysm in Patients with and without Antecedent Endovascular Repair. Ann Vasc Surg. 2017;39:99-104.
Catanescu, I., Long, G., Bove, P., Khoury, M., Brown, O., Rimar, S., Rizk, Y., Uzieblo, M., & Hans, S. (2017). Rupture of Abdominal Aortic Aneurysm in Patients with and without Antecedent Endovascular Repair. Annals of Vascular Surgery, 39, 99-104. https://doi.org/10.1016/j.avsg.2016.05.104
Catanescu I, et al. Rupture of Abdominal Aortic Aneurysm in Patients With and Without Antecedent Endovascular Repair. Ann Vasc Surg. 2017;39:99-104. PubMed PMID: 27522971.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rupture of Abdominal Aortic Aneurysm in Patients with and without Antecedent Endovascular Repair. AU - Catanescu,Irina, AU - Long,Graham, AU - Bove,Paul, AU - Khoury,Michael, AU - Brown,Otto, AU - Rimar,Steve, AU - Rizk,Youssef, AU - Uzieblo,Maciej, AU - Hans,Sachinder, Y1 - 2016/08/12/ PY - 2016/01/19/received PY - 2016/04/07/revised PY - 2016/05/18/accepted PY - 2016/8/16/pubmed PY - 2017/3/10/medline PY - 2016/8/16/entrez SP - 99 EP - 104 JF - Annals of vascular surgery JO - Ann Vasc Surg VL - 39 N2 - BACKGROUND: Reported results of ruptured abdominal aortic aneurysm (rAAA) in patients with antecedent endovascular aneurysm repair (EVAR) to those presenting with de novo rupture show a similar or slightly improved outcome. The aim of this study was to compare differences in the presentation and outcomes of rAAA with and without prior EVAR. METHODS: A retrospective review of 121 patients with rAAA, ruptured identified 2 groups. Group A included 17 patients (rAAA n = 17) with antecedent EVAR and group B consisted of 104 patients (rAAA n = 104) with de novo ruptures, from January 2001 to March 2015 in 3 teaching hospitals. Patient characteristics and perioperative variables were compared; Fisher's exact test was used for categorical variables. For continuous variables, Student's t-test and Mann-Whitney U test were used. RESULTS: Both groups were similar in age, gender, the incidence of hypertension, coronary artery disease, diabetes mellitus, chronic obstructive pulmonary disease, and nicotine abuse. Mean time of presentation from EVAR to rupture in group A was 42 ± 22 months. Mean preoperative transverse or anteroposterior diameter of AAA was 6.6 cm in group A and 7.1 cm in group B. Three patients of 17 (17.6%) in group A were hemodynamically unstable as compared to 47 of 104 patients (45.1%) in group B (P = 0.03). Mean red blood cells, fresh frozen plasma, and platelet transfusion were similar in both groups. Thirty-day mortality was 8 of 17 (44.7%) in group A and 44 of 104 (42.3%) in group B (P = 1.0). Postoperative complications were also similar in both groups except the incidence of postoperative respiratory failure was higher in group B (38%) as compared with 11.1% in group A (P = 0.001). CONCLUSIONS: Patients presenting with rAAA with antecedent EVAR are hemodynamically more stable as compared with patients with de novo rupture of AAA. Postoperative respiratory failure is more common in patients with de novo rupture. rAAA carry high mortality with and without prior EVAR. SN - 1615-5947 UR - https://www.unboundmedicine.com/medline/citation/27522971/Rupture_of_Abdominal_Aortic_Aneurysm_in_Patients_with_and_without_Antecedent_Endovascular_Repair_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0890-5096(16)30629-X DB - PRIME DP - Unbound Medicine ER -