Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Krenzien, F; Matia, I; Wiltberger, G; Hau, HM; Freitas, B; Moche, M; Schmelzle, M; Jonas, S; Fellmer, PT.
Outcome after open surgery repair in endovascular-suitable patients with ruptured abdominal aortic aneurysms.
Vasa. 2013; 42(6): 442-8.
Doi: 10.1024/0301-1526/a000314
Web of Science
PubMed
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FullText_MUG
- Co-Autor*innen der Med Uni Graz
- Hau Hans-Michael
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- Abstract:
- BACKGROUND: Endovascular aneurysm repair (EVAR) has been suggested in several studies to be superior to open surgery repair (OSR) for the treatment of ruptured abdominal aortic aneurysms (rAAAs), but this finding might be affected by selection bias based on aneurysm morphology and patient characteristics. We tested rAAA anatomy according to EVAR suitability in patients undergoing OSR to assess the impact on mortality. PATIENTS AND METHODS: This retrospective analysis reports on 83 patients with rAAAs treated between November 2002 and July 2013. Pre-operative computed tomography (CT) scans were evaluated based on EVAR suitability and were determined by blinded independent reviewers. CT scans were lacking due to acquisition in an external institution with no availability (n = 9) or solely ultrasound evaluations (n = 8). In addition patient characteristics and outcomes were assessed. RESULTS: All patients who underwent OSR and who had available preoperative CT scans were included in the study (n = 66). In summary, 42 % of the patients (28/66; 95 % confidence interval [CI], 30.5 - 54.4) were considered eligible for EVAR according to pre-operative CT scans and 58 % of the patients (38/66; 95 % CI, 45.6 - 69.5) were categorized as unsuitable for endovascular repair. Patients suitable for EVAR had a significantly lower prevalence of in-hospital deaths (25 % [7/28]; 95 % CI, 9 - 41) in contrast to patients unsuitable for EVAR (53 % [20/38]; 95 % CI, 36.8 - 68.5; p = 0.02). CONCLUSIONS: EVAR-suitable patients had a highly significant mortality reduction undergoing OSR. Thus, the present study proposes that EVAR suitability is a positive predictor for survival after open repair of rAAA.
- Find related publications in this database (using NLM MeSH Indexing)
- Aged - administration & dosage
- Aortic Aneurysm, Abdominal - diagnostic imaging, mortality, surgery
- Aortic Rupture - diagnostic imaging, mortality, surgery
- Aortography - methods
- Blood Vessel Prosthesis Implantation - adverse effects, mortality
- Chi-Square Distribution - administration & dosage
- Endovascular Procedures - adverse effects, mortality
- Female - administration & dosage
- Hospital Mortality - administration & dosage
- Humans - administration & dosage
- Logistic Models - administration & dosage
- Male - administration & dosage
- Multivariate Analysis - administration & dosage
- Patient Selection - administration & dosage
- Retrospective Studies - administration & dosage
- Risk Assessment - administration & dosage
- Risk Factors - administration & dosage
- Time Factors - administration & dosage
- Tomography, X-Ray Computed - administration & dosage
- Treatment Outcome - administration & dosage
- Find related publications in this database (Keywords)
- Abdominal
- aortic aneurysm
- aneurysm
- ruptured
- endovascular procedure
- spiral computed tomography