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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2015.1
- 수록면
- 81 - 86 (6page)
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Purpose: We analyze the outcomes of open repair (OR) in patients with ruptured abdominal aortic aneurysm (RAAA) according to the anatomic suitability for endovascular aneurysm repair (EVAR). Materials and Methods: We reviewed retrospectively all consecutive RAAA patients who underwent OR from January 2005 to March 2014. All suspected patients underwent preoperative computed tomography (CT). Outcomes were major morbidities and mortality. Multivariate analysis was performed by using logistic regression adjusted by controlled variables; gender, Hardman index, maximal aneurysmal diameter, rupture type, perioperative transfusion requirement, and perioperative urinary output. Results: Among 54 consecutive patients with RAAA who underwent OR, 45 patients were included after exclusion of 9 patients (7, suprarenal; 1, infected; 1, inflammatory). Preoperative CT showed 27% (12/45) EVAR-suitable patients. Hostile neck anatomy was found in 88% (29/33) among unsuitable anatomy (UA) (n=33). The maximal aneurysmal diameter was statistically larger (83.1±21.0 mm vs. 68.8±12.3 mm, P=0.032) in the UA group. The 30-day mortality was 28.9% (13/45; 33% vs. 17% in UA group vs. suitable anatomy [SA] group, P=0.460; adjusted P=0.445). UA group had more patients with cardiac morbidity (55% vs. 25%, P=0.079; adjusted P=0.032; odds ratio, 12.914; 95% confidence interval, 1.238-134.675). There was no statistical difference in survival rate between SA and UA groups (74.1%, 74.1%, and 74.1% vs. 60.6%, 55.6%, and 32.4% at 1-, 3- and 5-year, respectively; P=0.145). Conclusion: In this study, relatively unfavorable outcomes were found in the EVAR-unsuitable group after OR in RAAA patients. However, unsuitable anatomy did not influence patient survival after OR by multivariate analysis.
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참고문헌 (30)
참고문헌 신청
Mar in ML / 1995 / Initial experience with transluminally placed endovascular grafts for the treatment of complex vascular lesions / Ann Surg 222:449~465
Harkin DW / 2007 / Endovascular ruptured abdominal aortic aneurysm repair (EVRAR): a systematic review / Eur J Vasc Endovasc Surg 34:673~681
Mastracci TM / 2008 / Endovascular repair of ruptured abdominal aortic aneurysms:a systematic review and metaanalysis / J Vasc Surg 47:214~221
Karkos CD / 2011 / A meta-analysis and metaregression analysis of factors inf luencing mortality after endovascular repair of ruptured abdominal aortic aneurysms / Eur J Vasc Endovasc Surg 42:775~786
Bown MJ / 2002 / A meta-analysis of 50 years of ruptured abdominal aortic aneurysm repair / Br J Surg 89:714~730
Harkin DW / 2007 / Endovascular ruptured abdominal aortic aneurysm repair (EVRAR): a systematic review / Eur J Vasc Endovasc Surg 34:673~681
Mastracci TM / 2008 / Endovascular repair of ruptured abdominal aortic aneurysms:a systematic review and metaanalysis / J Vasc Surg 47:214~221
Karkos CD / 2011 / A meta-analysis and metaregression analysis of factors inf luencing mortality after endovascular repair of ruptured abdominal aortic aneurysms / Eur J Vasc Endovasc Surg 42:775~786
Bown MJ / 2002 / A meta-analysis of 50 years of ruptured abdominal aortic aneurysm repair / Br J Surg 89:714~730
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