Rose Daniel F G, Davidson Ian R, Hinchliffe Robert J, Whitaker Simon C, Gregson Roger H, MacSweeney Shane T, Hopkinson Brian R
University Hospital Nottingham, England, UK.
J Endovasc Ther. 2003 Jun;10(3):453-7. doi: 10.1177/152660280301000309.
To assess the anatomical suitability of ruptured abdominal aortic aneurysms (AAA) for emergency endovascular repair.
All cases (46 patients [35 men; mean age 74 years, range 54-85]) in which computed tomographic angiography (CTA) confirmed AAA rupture over a 5-year period at our university hospital were reviewed for anatomical suitability for endovascular repair. Measurements were made by a radiologist experienced in anatomical assessment of CT criteria for elective endovascular aneurysm repair (EVAR).
The mean aneurysm neck length was 18 mm (range 0-59); 17 were conical, 13 straight, 4 barrel, and 6 reverse conical. Six cases had no proximal neck. Overall, 37 (80%) patients were unsuitable for EVAR according to our criteria. Nearly half the patients (22, 48%) had > or =2 adverse features. Unsuitable neck morphology (35, 76%) was the primary reason for exclusion, but CIA aneurysm (10, 22%) and EIA tortuosity (7, 15%) were secondary adverse features.
With current stent-graft design, the majority of ruptured abdominal aortic aneurysms are anatomically unsuitable for endovascular repair.
