Mueller Paul S, Albin Scott M, Barnes Roxann D, Rasmussen Keith G
Division of General Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA.
J ECT. 2009 Sep;25(3):165-9. doi: 10.1097/YCT.0b013e31819a61e5.
Patients with unrepaired abdominal aortic aneurysm (AAA) may have depression and other psychiatric disorders for which electroconvulsive therapy (ECT) may be recommended. It is unclear whether ECT, which transiently, yet markedly, increases blood pressure and heart rate, can be safely performed in patients with AAA. We investigated the safety of ECT in patients with unrepaired AAA.
A retrospective review was conducted of the medical records of all patients with unrepaired AAA who underwent ECT for severe depressive syndromes at Mayo Clinic, Rochester, Minn, between January 1, 1995, and June 30, 2007.
Eight patients (5 men and 3 women) with unrepaired AAA who underwent ECT were identified. Median age was 78.5 years (range, 67-83 years). All patients had AAA (median diameter, 3.95 cm [range, 3.0-5.2 cm]). The median number of treatments was 8.5 (range, 4-48). None of the patients died during the periprocedural period or experienced symptoms or signs suggestive of AAA expansion or rupture. Follow-up imaging data were available for 6 patients whose median post-ECT AAA diameter was 4.65 cm (range, 3.3-5.3 cm). Expansion of AAA ranged from 0.1 cm (for 11 and 13 months in 2 patients) to 1.0 cm (for 29 months in 1 patient), which is less than the expected mean expansion rates for AAAs of these diameters.
Electroconvulsive therapy was safe for 8 patients with unrepaired AAA treated at our institution. Our findings may be informative to clinicians who manage the care of patients with unrepaired AAA who are undergoing ECT.
未修复腹主动脉瘤（AAA）患者可能患有抑郁症和其他精神疾病，对此可能会推荐采用电休克治疗（ECT）。目前尚不清楚在AAA患者中能否安全进行ECT，因为ECT会使血压和心率短暂但显著升高。我们研究了ECT在未修复AAA患者中的安全性。
对1995年1月1日至2007年6月30日期间在明尼苏达州罗切斯特市梅奥诊所因严重抑郁综合征接受ECT治疗的所有未修复AAA患者的病历进行回顾性分析。
确定了8例接受ECT治疗的未修复AAA患者（5例男性和3例女性）。中位年龄为78.5岁（范围为67 - 83岁）。所有患者均患有AAA（中位直径为3.95 cm[范围为3.0 - 5.2 cm]）。治疗次数中位数为8.5次（范围为4 - 48次）。围手术期无患者死亡，也未出现提示AAA扩张或破裂的症状或体征。6例患者有ECT后影像学随访数据，其AAA中位直径为4.65 cm（范围为3.3 - 5.3 cm）。AAA扩张范围为0.1 cm（2例患者分别为11个月和13个月）至1.0 cm（1例患者为29个月），低于这些直径AAA的预期平均扩张率。
在我们机构，ECT对8例未修复AAA患者是安全的。我们的研究结果可能会为管理正在接受ECT治疗的未修复AAA患者的临床医生提供参考。
