Ioannidis O, Trellopoulos G, Tamouridis G, Konstantinidis K, Megalopoulos A
First Surgical Department, General Regional Hospital George Papanikolaou, Thessaloniki, Greece.
Int Angiol. 2012 Aug;31(4):386-92.
The treatment of ruptured abdominal aortic aneurysms is a constant challenge for vascular surgeons and can be achieved either by endovascular repair or by an open surgical technique. Endovascular repair presents a higher 30-day survival rate. The aim of this study was to compare the clinical and anatomical characteristics and the outcomes of these two treatment techniques.
Our study sample comprised patients who presented at the emergency department of a General Regional Hospital with rupture of an abdominal aortic aneurysm between January 2003 and December 2008. Of the 43 patients who were treated, 23 underwent open surgical repair and 20 underwent endovascular repair.
Comorbidities, age, clinical presentation and anatomical characteristics didn't present statistically significant differences in the two groups. Patients in the endovascular repair group were transfused with less units of blood and fresh frozen plasma (P=0.001) and had shorter stay in the intensive care unit (P=0.042). The 30-day mortality rate was 43% for open surgical repair and 35% for endovascular treatment (P=0.627), while the overall in-hospital mortality rate was 61% and 50% (P=0.474), respectively.
When certain anatomical characteristics are present and the hemodynamic condition of the patient allows it, endovascular treatment appears to be associated with better survival rates, both 30-day and overall.
腹主动脉瘤破裂的治疗对血管外科医生而言始终是一项挑战，可通过血管腔内修复术或开放手术技术来实现。血管腔内修复术的30天生存率更高。本研究的目的是比较这两种治疗技术的临床和解剖学特征及治疗效果。
我们的研究样本包括2003年1月至2008年12月期间在一家地区综合医院急诊科因腹主动脉瘤破裂就诊的患者。在接受治疗的43例患者中，23例行开放手术修复，20例行血管腔内修复。
两组患者的合并症、年龄、临床表现和解剖学特征无统计学显著差异。血管腔内修复组患者输注的血液和新鲜冰冻血浆单位较少（P = 0.001），在重症监护病房的住院时间较短（P = 0.042）。开放手术修复的30天死亡率为43%，血管腔内治疗为35%（P = 0.627），而总体住院死亡率分别为61%和50%（P = 0.474）。
当存在某些解剖学特征且患者的血流动力学状况允许时，血管腔内治疗似乎与30天和总体的更好生存率相关。
