Long-term outcomes following endovascular aneurysm repair for ruptured abdominal aortic aneurysms

Aurélien M. Guéroult, Farhaan A. Khan, Philip W. Stather, Seamus C. Harrison, Jonathan R. Boyle

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5 Citations (Scopus)

Abstract

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.
Original languageEnglish
Pages (from-to)428-435
Number of pages8
JournalJournal of Endovascular Therapy
Volume27
Issue number3
Early online date9 Jun 2020
DOIs
Publication statusPublished - Jun 2020

Keywords

  • abdominal aortic aneurysm
  • aortic rupture
  • complications
  • emergency procedure
  • endograft
  • endoleak
  • endovascular aneurysm repair
  • mortality
  • reintervention
  • stent-graft

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