Journal of Medical Case Reports and Reviews

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COMPARISON OF POSTOPERATIVE DATA AND SURVIVAL IN PATIENTS WITH AND WITHOUT RUPTURE IN INFRA-ABDOMINAL AORTIC ANEURYSMS: 23 YEARS EXPERIENCE

Bilgehan Erkut
Atatürk University, Medical Faculty, Department of Cardiovascular Surgery, Erzurum, TURKEY.
  • Articles
  • Submited: June 4, 2019
  • Published: June 15, 2019

Abstract

Infrarenal abdominal aortic aneurysms are responsible for high rates of rupture-associated morbidity and mortality and can be treated by open or endovascular surgery. We compared the postoperative data and vital functions of the patients who had undergone open surgery for ruptured and non-ruptured infra-renal abdominal aortic aneurysms.

Between January 1996 and March 2019, 84 patients (62 males, 22 females) underwent open surgical repair because of infrarenal abdominal aortic aneurysm in 2 separate hospitals in our region. The mean age of our patients was 71.5 ± 6.4 years (range 48-81 years). The patients were divided into two groups. Group I patients were composed of 45 patients and these patients were taken under elective conditions before the rupture occurred. The number of patients in Group II was 39 and these patients were operated after rupture. Group II patients underwent surgical treatment in emergency conditions and in an unstable hemodynamic state. In Group II patients, the duration of intensive care unit and hospitalization was higher than Group I. In addition, hospital costs were higher in Group II patients. 26 patients (30.9%) in Group II and 5 patients (5.9%) in Group I died in the early and postoperative period.

According to this retrospective study, operative repair before rupture in infra-renal abdominal aortic aneurysms decreases morbidity and mortality rates, statistically. Therefore, patients who are diagnosed with infra-renal abdominal aortic aneurysm and do not reach the surgical conditions should be followed up as closely as possible and should be operated before rupture when the surgical indication is established.

References

1. Guirguis-Blake JM, Beil TL, Senger CA, Whitlock EP. Ultrasonography screening for abdominal ortic aneurysms: a systematic evidence review for the U.S. Preventive Services Task Force. Ann Intern Med 2014; 160: 321-29.
2. US Preventive Services Task Force. Screening for abdominal aortic aneurysm: U.S. preventive services task force recommendation statement. Ann Intern Med 2014; 161: 281-90.
3. Centers for Disease Control. Deaths, percent of total deaths, and death rates for the 15 leading causes of death in 5-year age groups, by race and sex: United States, 2013.
4. Bitargil M, Bektas N, Omeroglu S, Koramaz I. Surgical Repair of a 13-cm Infrarenal Abdominal Aortic Aneurysm with Aortocaval Fistula in a 63-Year-Old Tuba Player. Tex Heart Inst J. 2019 Feb 1;46(1):36-40.
5. Ashton HA, Buxton MJ, Day NE, Kim LG, Marteau TM, Scott RA, et al. The Multicentre Aneurysm Screening Study (MASS) into the effect of abdominal aortic aneurysm screening on mortality in men: a randomised controlled trial. Lancet 2002:360: 1531-39.
6. Kocher M, Utikal P, Koutna J, Bachleda P, Buriankova E, Herman M, et al. Endovascular treatment of abdominal aortic aneurysms-6 years of experience with Ella stentgraft system. Eur J Radiol 2004: 51: 181-88.
7. Chun KC, Teng KY, Van Spyk EN, Carson JG, Lee ES. Outcomes of an abdominal aortic aneurysm screening program. J Vasc Surg 2013; 57: 376-81.

8. Brown PM, Zelt DT, Sobolev B. The risk of rupture in untreated aneurysms: the impact of size, gender, and expansionrate. J Vasc Surg 2003;37(2):280-4.
9. Hollier L, Wisselink W. Abdominal aortic aneurysm. Haimovici’s Vascular Surgery In: Haimovici H, eds Massachusetts: Blackwell Science 1996: 797-827.
10. Chaikof EL, Brewster DC, Dalman RL, Makaroun MS, Illig KA, Sicard GA, et al. Society for Vascular Surgery. The care of patients with an abdominal aortic aneurysm: the Society for Vascular Surgery practice guidelines. J Vasc Surg 2009; 50: S2-49.
11. Mell MW, Callcut RA, Bech F, Delgado MK, Staudenmayer K, Spain DA, et al. Predictors of emergency department death for patients presenting with ruptured abdominal aortic aneurysms. J Vasc Surg 2012; 56: 651-5.
12. Koçak H, Özyazıcıoglu A. Abdominal Aort Anevrizmaları. Kalp ve Damar Cerrahisi In: Duran E, eds İstanbul: Çapa Tıp Kitabevi, 1 Edition. 2004:725-741.
13. Sakalihasan N, Michel JB, Katsargyris A, Kuivaniemi H, Defraigne JO, Nchimi A, Powell JT, Yoshimura K, Hultgren R. Abdominal aortic aneurysms. Nat Rev Dis Primers. 2018 Oct 18;4(1):34.
14. Novero ER, Metzger PB, Angelieri F, et al. Correção endovascular do aneurisma da aorta abdominal: análise dos resultados de único centro. Radiol Bras. 2012;45(1):1-6.
15. de Jesus-Silva SG, de Oliveira VR, de Moraes-Silva MA, Krupa AE, Cardoso RS.Risk factors and short and mediumterm survival after open and endovascular repair of abdominal aortic aneurysms. J Vasc Bras. 2018; 17(3): 201-207.
16. Mastracci TM, Cinà CS. Canadian Society for vascular surgery. Screening for abdominal aortic aneurysm in Canada: review and position statement of the Canadian Society for Vascular Surgery. J Vasc Surg. 2007;45(6):1268-76.
17. Chuter TA, Reilly LM, Faruqi RM, et al. Endovascular aneurysm repair in high-risk patients. J Vasc Surg. 2000; 31(1Pt 1):122-33.
18. Taylor L, Porter LM. Basic data releated to clinical decision – making in abdominal aortic aneurysm. Ann Vasc Surg 1980; 1: 502-4.
19. Hirsch A, Haskal ZJ, Hertzer NR, Bakal CW, Creager MA, Halperin JL, et al. ACC/AHA 2005 Practice Guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease): endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation. Circulation 2006; 113(11): e463-654.
20. Sakamaki F, Oya H, Nagaya N, Kyotani S, Satoh T, Nakanishi N. Higher prevalence of obstructive airway disease in patients with thoracic or abdominal aortic aneurysm. J Vasc Surg 2002; 36: 35-40.

21. Brown LC, Powell JT. UK small aneurysm trial participants. Risk factors for aneurysm rupture in patients kept under ultrasound surveillance. Ann Surg 1999; 230: 289-97.
22. Bown MJ, Sutton AJ, Bell PRF, Sayers RD. A meta-analyses of 50 years of ruptured abdominal aortic aneurysm repair. Br J Surg 2002; 89: 714-30.
23. Thompson SG, Ashton HA, Gao L, Scott RAP. Screening men for abdominal aortic aneurysm: 10 year mortality and cost effectiveness results from the randomised Multicentre Aneurysm Screening Study. BMJ 2009; 338: b2307.
24. Buket S, Bilgen F, Battaloğlu B, Gürbüz A, Alhan C. Abdominal Aort Anevrizması. Türk Kalp Damar Cerrahisi Derneği Aort Cerrahisinde Tanı ve Tedavi Kılavuzu In: Fuat Bilgen, eds: Güneş Tıp Kitabevleri. 2008: 36-56.
25. Tang Y, Chen J, Huang K, Luo D, Liang P, Feng M, Chai W, Fung E, Lan HY, Xu A. The incidence, risk factors and in-hospital mortality of acute kidney injury in patients after abdominal aortic aneurysm repair surgery. BMC Nephrol. 2017 May 31;18(1):184.
26. Kopolovic I, Simmonds K, Duggan S, Ewanchuk M, Stollery DE, et al. Risk factors and outcomes associated with acute kidney injury following ruptured abdominal aortic aneurysm. BMC Nephrol. 2013; 14: 99.
27. Yue JN, Luo Z, Guo DQ, Xu X, Chen B, et al. Evaluation of acute kidney injury as defined by the risk, injury, failure, loss, and end-stage criteria in critically ill patients undergoing abdominal aortic aneurysm repair. Chin Med J. 2013;126:431–6.


28. Williamson JS, Ambler GK, Twine CP, Williams IM, Williams GL. Elective Repair of Abdominal Aortic Aneurysm and the Risk of Colonic Ischaemia: Systematic Review and Meta-Analysis. Eur J Vasc Endovasc Surg. 2018; 56(1):31-39.
29. Kotsis T, Christoforou P, Asaloumidis N, Papaconstantinou I. Delayed Sigmoid Ischemic Rupture Following Open Repair Abdominal Aortic Aneurysm. Vasc Endovascular Surg. 2017 Aug;51(6):413-416.
How to Cite
Erkut, B. (2019). COMPARISON OF POSTOPERATIVE DATA AND SURVIVAL IN PATIENTS WITH AND WITHOUT RUPTURE IN INFRA-ABDOMINAL AORTIC ANEURYSMS: 23 YEARS EXPERIENCE. Jmcrr, 2(6). Retrieved from http://jmcrr.info/index.php/jmcrr/article/view/78
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