PURPOSE: It is still difficult to determine the appropriate timing of surgery for a symptomatic abdominal aortic aneurysm (AAA). Since recent developments in computed tomography (CT) have made the procedure substantially less time-consuming, we used CT on patients with symptomatic AAA to determine the most appropriate management option. METHODS: CT was performed on 79 patients with symptomatic AAA. If rupture of the AAA was confirmed by CT, patients underwent emergency surgery. If there was no rupture, patients were observed in an intensive care unit, and surgery was scheduled according to the results of repeated CT (2.1 times on average) and physical examinations, as well as on their clinical signs and symptoms. RESULTS: By CT, we identified 42 ruptures, one contained rupture, one aortocaval fistula, five acute aortic dissections with AAAs, six inflammatory AAAs, six pseudoaneurysms and 18 non-ruptured AAAs. The mortality rate of the patients with ruptures was 33%. For the 37 patients without rupture, as determined by CT, three emergency, nine urgent, and 20 elective operations were performed. Two patients who refused surgery experienced late rupture and died. Among the other 35 patients, the mortality rate was 6%. CONCLUSION: CT was an effective modality to classify patients with symptomatic AAA into those who needed emergency surgery and those who did not. We could observe patients with symptomatic non-ruptured AAAs before urgent/elective operations by repeated CT and monitor the clinical findings.
PURPOSE: It is still difficult to determine the appropriate timing of surgery for a symptomatic abdominal aortic aneurysm (AAA). Since recent developments in computed tomography (CT) have made the procedure substantially less time-consuming, we used CT on patients with symptomatic AAA to determine the most appropriate management option. METHODS: CT was performed on 79 patients with symptomatic AAA. If rupture of the AAA was confirmed by CT, patients underwent emergency surgery. If there was no rupture, patients were observed in an intensive care unit, and surgery was scheduled according to the results of repeated CT (2.1 times on average) and physical examinations, as well as on their clinical signs and symptoms. RESULTS: By CT, we identified 42 ruptures, one contained rupture, one aortocaval fistula, five acute aortic dissections with AAAs, six inflammatory AAAs, six pseudoaneurysms and 18 non-ruptured AAAs. The mortality rate of the patients with ruptures was 33%. For the 37 patients without rupture, as determined by CT, three emergency, nine urgent, and 20 elective operations were performed. Two patients who refused surgery experienced late rupture and died. Among the other 35 patients, the mortality rate was 6%. CONCLUSION: CT was an effective modality to classify patients with symptomatic AAA into those who needed emergency surgery and those who did not. We could observe patients with symptomatic non-ruptured AAAs before urgent/elective operations by repeated CT and monitor the clinical findings.
Authors: M R Kapma; E L G Verhoeven; I F J Tielliu; C J A M Zeebregts; T R Prins; B Van der Heij; J J A M Van den Dungen Journal: Eur J Vasc Endovasc Surg Date: 2005-05 Impact factor: 7.069
Authors: Manish Mehta; John Taggert; R Clement Darling; Benjamin B Chang; Paul B Kreienberg; Philip S K Paty; Sean P Roddy; Yaron Sternbach; Kathleen J Ozsvath; Dhiraj M Shah Journal: J Vasc Surg Date: 2006-07 Impact factor: 4.268
Authors: L L Hoornweg; W Wisselink; A C Vahl; J A Reekers; O M van Delden; D A Legemate; R Balm Journal: Eur J Vasc Endovasc Surg Date: 2007-11-07 Impact factor: 7.069
Authors: R A Cambria; P Gloviczki; A W Stanson; K J Cherry; J W Hallett; T C Bower; P C Pairolero Journal: Ann Vasc Surg Date: 1994-03 Impact factor: 1.466
Authors: Benjamin W Starnes; Elina Quiroga; Carolyn Hutter; Nam T Tran; Thomas Hatsukami; Mark Meissner; Gale Tang; Ted Kohler Journal: J Vasc Surg Date: 2009-11-01 Impact factor: 4.268