Lyons Oliver T A, Black Stephen, Clough Rachel E, Bell Rachel E, Carrell Tom, Waltham Matthew, Sabharwal Tarun, Reidy John, Taylor Peter R
Department Vascular Surgery, Guy's & St Thomas' NHS Foundation Trust, London, England.
Vascular. 2010 May-Jun;18(3):130-5. doi: 10.2310/6670.2010.00033.
We present the early results of a policy of treating all anatomically suitable ruptured abdominal aortic aneurysms (rAAAs) by emergency endovascular aneurysm repair (eEVAR), regardless of hemodynamic instability. Data were retrospectively collected from prospectively maintained databases identifying patients with rAAA from 2006 to 2007. Forty-seven patients with true rAAA were identified (87% men; median age 76 years [range 63-97 years]), of whom 18 (38%) were treated with eEVAR, 19 (40%) received open aneurysm repair (OAR), and 10 (21%) were managed nonoperatively. Fifteen of 18 (83%) eEVAR patients received an aortouni-iliac device + femorofemoral crossover, 2 patients (11%) had bifurcated devices, and 1 patient (6%) had a new iliac limb. Thirty-day mortality was 11% (2 of 18) for eEVAR and 32% (6 of 19) for OAR (p = not significant). At the 6-month follow-up, mortality was 22% (4 of 18) for eEVAR and 37% (7 of 19) for OAR (p = not significant). A clinically significant early survival advantage is suggested for eEVAR in patients presenting with rAAA.
我们展示了一项针对所有解剖结构适合的破裂腹主动脉瘤（rAAA）采用急诊血管腔内修复术（eEVAR）进行治疗的策略的早期结果，无论患者血流动力学是否稳定。数据是从2006年至2007年前瞻性维护的数据库中回顾性收集的，这些数据库用于识别患有rAAA的患者。共识别出47例真性rAAA患者（87%为男性；中位年龄76岁[范围63 - 97岁]），其中18例（38%）接受了eEVAR治疗，19例（40%）接受了开放性动脉瘤修复术（OAR），10例（21%）接受了非手术治疗。18例eEVAR患者中有15例（83%）接受了主动脉单髂动脉装置+股股交叉搭桥术，2例（11%）使用了分叉装置，1例（6%）使用了新的髂动脉分支。eEVAR组30天死亡率为11%（18例中的2例），OAR组为32%（19例中的6例）（p值无统计学意义）。在6个月随访时，eEVAR组死亡率为22%（18例中的4例），OAR组为37%（19例中的7例）（p值无统计学意义）。对于出现rAAA的患者，eEVAR显示出具有临床意义的早期生存优势。
