OBJECTIVE: Compared with conventional open surgery (COS), endovascular aneurysm repair (EVAR) has been reported to decrease the 30-day mortality rate in patients with ruptured abdominal aortic aneurysms (rAAAs). We developed an EVAR-first strategy for rAAAs that incorporates the Shonan ruptured abdominal aortic aneurysm protocol (SRAP). We describe short-term results with this protocol at our institution and compare them with outcomes in patients who underwent COS. METHODS: The records of all 57 patients in whom a rAAA was repaired during a 7-year period were reviewed retrospectively. Patients in the COS group (n = 30) were treated between January 2005 and December 2009; those in the SRAP group (n = 27) were treated between January 2010 and March 2012. The two groups were compared with respect to patient characteristics at admission, including severity of condition; operative and in-hospital variables; and 30-day mortality. RESULTS: The baseline patient characteristics in the COS and SRAP groups were similar except that the SRAP group had a significantly higher rate of cerebrovascular disease. The 30-day mortality rate was significantly higher in the COS group (43% vs. 19%), as were the intraoperative mortality rate (27% vs. 5%) and the in-hospital mortality rate (57% vs. 26%; P < 0.05 for all comparisons). The technical success rate for EVAR was 96%; no conversions to open surgery were required. CONCLUSIONS: Use of the SRAP is a promising strategy for improving initial outcomes in patients with rAAAs.
OBJECTIVE: Compared with conventional open surgery (COS), endovascular aneurysm repair (EVAR) has been reported to decrease the 30-day mortality rate in patients with ruptured abdominal aortic aneurysms (rAAAs). We developed an EVAR-first strategy for rAAAs that incorporates the Shonan ruptured abdominal aortic aneurysm protocol (SRAP). We describe short-term results with this protocol at our institution and compare them with outcomes in patients who underwent COS. METHODS: The records of all 57 patients in whom a rAAA was repaired during a 7-year period were reviewed retrospectively. Patients in the COS group (n = 30) were treated between January 2005 and December 2009; those in the SRAP group (n = 27) were treated between January 2010 and March 2012. The two groups were compared with respect to patient characteristics at admission, including severity of condition; operative and in-hospital variables; and 30-day mortality. RESULTS: The baseline patient characteristics in the COS and SRAP groups were similar except that the SRAP group had a significantly higher rate of cerebrovascular disease. The 30-day mortality rate was significantly higher in the COS group (43% vs. 19%), as were the intraoperative mortality rate (27% vs. 5%) and the in-hospital mortality rate (57% vs. 26%; P < 0.05 for all comparisons). The technical success rate for EVAR was 96%; no conversions to open surgery were required. CONCLUSIONS: Use of the SRAP is a promising strategy for improving initial outcomes in patients with rAAAs.
Authors: Manish Mehta; R Clement Darling; Sean P Roddy; Scott Fecteau; Kathleen J Ozsvath; Paul B Kreienberg; Philip S K Paty; Benjamin B Chang; Dhiraj M Shah Journal: J Vasc Surg Date: 2005-12 Impact factor: 4.268
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: Monique Prinssen; Eric L G Verhoeven; Jaap Buth; Philippe W M Cuypers; Marc R H M van Sambeek; Ron Balm; Erik Buskens; Diederick E Grobbee; Jan D Blankensteijn Journal: N Engl J Med Date: 2004-10-14 Impact factor: 91.245
Authors: M L Marin; F J Veith; J Cynamon; L A Sanchez; R T Lyon; B A Levine; C W Bakal; W D Suggs; K R Wengerter; S P Rivers Journal: Ann Surg Date: 1995-10 Impact factor: 12.969