Emergency endovascular repair for ruptured abdominal aneurysms - a feasibility study and report of 10 cases

Abstract

BACKGROUND: Endovascular aneurysm repair (EVAR) has been proved to be effective and safe in the elective management of abdominal aortic aneurysms (AAAs). Initial reports concerning endovascular management of ruptured aneurysms have been promising. OBJECTIVE: To determine the outcome of endovascular repair of ruptured aneurysms in the local setting. MATERIALS & METHODS: Patients who presented with ruptured AAAs were considered for endovascular repair if they were haemodynamically stable and had suitable aneurysm morphology for EVAR. RESULTS: Ten patients (9 males, 1 female) with a mean age of 74.9 years were treated. All aneurysms were successfully excluded using aorta uni-iliac stent grafts in 7 patients and bifurcated stent grafts in 2 patients. In 1 patient who had had a previous EVAR, a proximal extension device was used. Two patients died in the peri-operative period (30-day mortality of 20%) and 1 patient died after 2 months. Seven patients are still alive. No endo-leaks occurred in any of the survivors. CONCLUSION: Endovascular repair of ruptured AAAs is feasible with acceptable peri-operative mortality and short- to medium-term results.