Van Schaik D E, Dolmans D E J G, Ho G, Geenen G P, Vos L, Van Der Waal J C, De Groot H G, Van Der Laan L
Department of Surgery, Amphia Hospital, Breda, The Netherlands.
J Cardiovasc Surg (Torino). 2011 Jun;52(3):363-9.
We compared the outcomes of 56 patients with a ruptured abdominal aortic aneurysm (RAAA) who underwent either open repair or emergency endovascular aneurysm repair (eEVAR) in a general hospital. It seems feasible that the availability of eEVAR for treatment of RAAA could lead to a decrease in hospital mortality.
We analyzed all admitted patients with a RAAA, between January 2006 and April 2008, eEVAR is compared to open repair. We studied 30 days mortality, intensive care unit stay, hospital stay, total blood loss and complications.
Fifteen eEVAR procedures (26.8%) were performed. Mortality in the eEVAR-group was 26%, in the open repair-group 46%. Mean intensive care unit stay was 3.9 days and 4.8 days in the eEVAR-group and open repair-group, respectively. Mean hospital stay was 13 days and 10.5 days. The average blood loss was 210cc and 2760cc. The amount of blood products for transfusion was significantly higher in the open repair. Overall complication rate was not significantly different in both treatment groups.
Treatment in a Dutch general hospital of a RAAA with an eEVAR procedure has a lower mortality in comparison to the open repair. Therefore, whenever possible the eEVAR is the preferred treatment method.
我们比较了56例腹主动脉瘤破裂（RAAA）患者在一家综合医院接受开放修复或急诊血管腔内动脉瘤修复（eEVAR）的治疗结果。对于RAAA患者，采用eEVAR进行治疗可能会降低医院死亡率，这似乎是可行的。
我们分析了2006年1月至2008年4月期间所有收治的RAAA患者，将eEVAR与开放修复进行比较。我们研究了30天死亡率、重症监护病房住院时间、住院时间、总失血量和并发症情况。
共进行了15例eEVAR手术（26.8%）。eEVAR组的死亡率为26%，开放修复组为46%。eEVAR组和开放修复组的平均重症监护病房住院时间分别为3.9天和4.8天。平均住院时间分别为13天和10.5天。平均失血量分别为210cc和2760cc。开放修复组的输血用血液制品量显著更高。两个治疗组的总体并发症发生率无显著差异。
在一家荷兰综合医院，采用eEVAR治疗RAAA的死亡率低于开放修复。因此，只要有可能，eEVAR就是首选的治疗方法。
