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  • Title: Percutaneous endovascular repair of ruptured abdominal aortic aneurysms.
    Author: Najjar SF, Mueller KH, Ujiki MB, Morasch MD, Matsumura JS, Eskandari MK.
    Journal: Arch Surg; 2007 Nov; 142(11):1049-52. PubMed ID: 18025332.
    Abstract:
    HYPOTHESIS: Percutaneous endovascular repair of ruptured abdominal aortic aneurysms (RAAAs) has better outcomes than traditional open surgical repair. DESIGN: Single-center retrospective review. SETTING: University hospital tertiary referral center. PATIENTS: Thirty-seven RAAAs treated using endovascular repair (n = 15) or open surgery (n = 22). INTERVENTIONS: From January 1, 2000, through December 31, 2005, 15 RAAAs were treated with endovascular stent graft exclusion using commercially available systems. Twenty-two other patients undergoing standard open surgical repair during the same interval comprised a control group for comparison. MAIN OUTCOME MEASURES: Early outcomes of percutaneous endovascular repair of RAAAs. RESULTS: Among the endovascular group, the mean +/- SD age was 73 +/- 9.8 years, 86.6% were men (n = 13), and 20.0% had a preoperative systolic blood pressure of 80 mm Hg or lower (n = 3). An entirely percutaneous procedure was performed in the final 11 patients using arterial closure systems. Technical success of attempted endovascular exclusion was 100.0%. The mean +/- SD procedure time (107 +/- 30 minutes), transfusion requirements (6.6 +/- 4.7 U), and length of stay (3.0 +/- 6.8 days) were statistically significantly reduced compared with open surgery. The 30-day mortality was 6.7% (1 of 15) compared with an open surgery 30-day mortality of 13.6% (3 of 22). No late complications (pseudoaneurysm, infection, lymphocele, or neuropathy) occurred after a completely percutaneous technique during a mean follow-up of 12 months. CONCLUSION: Percutaneous endovascular repair of RAAAs is a more expedient and less morbid alternative than open surgical repair.
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