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IS ENDOVASCULAR REPAIR OF RUPTURED ABDOMINAL AORTIC ANEURYSMS CHANGING THE SELECTION CRITERIA FOR INTERVENTION? – A 5 YEAR RETROSPECTIVE AUDIT IN A SMALL TEACHING HOSPITAL
Author(s) -
Arvapalli V. K.,
Walker S.,
Beasley T.
Publication year - 2007
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2007.04134_18.x
Subject(s) - medicine , retrospective cohort study , audit , referral , surgery , tertiary referral hospital , general surgery , nursing , management , economics
Purpose Endovascular repair (EVR) of ruptured abdominal aortic aneurysms (RAAA) holds great promise in the treatment of this usually fatal condition. We aim to demonstrate how the impact of EVR of RAAA has started to alter our practise. Methodology A retrospective review of all patients presenting with RAA to a small tertiary referral teaching hospital. Results Between January 2001 and September 2006, 76 patients presented with RAAA. One refused surgery and 26 were treated palliatively, all but one died. Forty four underwent conventional open repair (OR) of RAAA (32 men, mean age 68.3 years) and 5 had EVR (4 men, mean age 78.5 years). All patients who underwent EVR would previously have been declined OR due to medical co‐morbidities. The mean annual 30 day mortality for OR was 57% but this has fallen from 70% in 2002 to 25% in 2006. The 30 day mortality for EVR of RAAA was 0%. Mean hospital stay following OR was 20.4 days and following EVR was 17.5 days but mean ICU length of stay was unchanged at 10 days. Conclusion Despite recent improvements in survival following OR of RAAA, our initial experience of EVR suggests that we can still do better. Should we be offering this new technology to patients we would previously have declined OR?