Ruptured abdominal aortic aneurysms a study of prevalence, associated comorbidities, intervention techniques and mortality
Tran, Q and Herlihy, D and Tran, V and Puttaswamy, V, Ruptured abdominal aortic aneurysms a study of prevalence, associated comorbidities, intervention techniques and mortality, pp. 39-39. ISSN 1742-6731 (2020) [Conference Extract]
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Background: Improving outcomes for patients with ruptured abdominal aortic aneurysms (rAAA) remains a
challenging paradigm despite the utilisation of rapid
emergency medical transport systems and the development of improved intraoperative anaesthetic and surgical
Objectives: To analyse the incidence of rAAAs and to
compare mortality associated with open versus endovascular repair.
Method: A retrospective analysis of patients presenting
with rAAAs between January 2010 and March 2018
was conducted using data from the Australasian Vascular Audit (AVA). Patients who did not undergo a procedure, had a suprarenal, mycotic or isolated iliac
aneurysm, or had a previous repair were excluded.
Results: 52 patients were identified, of which 87% were
male with a mean age of 78.3 years. There were 7 deaths
of which 14% had IHD, 71% had hypertension, 57%
were ex-smokers and no patients were recorded to have
a history of diabetes. 19 patients (37%) underwent open
repair, 31 (60%) successful endoluminal repair and
2 (4%) required conversion to open repair. Mortality
was 26%, 13% and 100% respectively. The median
(IQ range) diameter was 8.0 cm (6.0–9.0) and in the
three groups 8.5 cm (7.3–9.0), 7.0 cm (6.0–8.0) and
9.0 cm (8.5–9.5) respectively. Seven rAAAs were less
than 6 cm in diameter.
Conclusion: Patients undergoing endoluminal repair for
rAAA had significantly better survival than those undergoing open repair (P = 0.035). The mean diameter of
rAAAs is higher than the threshold diameters usually
suggested for elective repair. With rAAA still associated
with a high morbidity and mortality, a protocol is being
formulated at Royal North Shore Hospital to ensure
expediated surgical intervention.