The utility of commercially available endografts in the treatment of contained ruptured abdominal aortic aneurysm with hemodynamic stability

Joseph V. Lombardi, Ronald M. Fairman, Michael A. Golden, Jeffrey P. Carpenter, Marc Mitchell, Clyde Barker, Amy McBride, Omaida C Velazquez

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Purpose Food and Drug Administration-approved endografts are suitable for the elective repair of abdominal aortic aneurysms (AAAs) with favorable aneurysm anatomy. Our aim is to illustrate the feasibility and versatility of commercially available endografts for emergency AAA repair in hemodynamically stable AAA rupture. Methods From June 2001 to July 2002, five patients presented with severe abdominal pain and were diagnosed with contained rupture of an infrarenal AAA. In all cases, patients were deemed unfit to withstand conventional open repair by both the referring outside medical center as well as our center's team. All patients were hemodynamically stable on arrival at our medical center. Measurement and selection of endovascular devices were based on computed tomography (CT) scans performed emergently at the outside referring center. The required emergently procured endografts were obtained within 2 to 4.5 hours (mean, 3.1 hours) of presentation. Complex anatomy at the proximal and distal fixation zones or difficult access was present in every case. Results All patients survived endograft repair and had successful exclusion of their aneurysm sac on the basis of intraoperative arteriography and postoperative CT surveillance. All were discharged to home at baseline function within a mean of 6.8 days (range, 2-13 days). There were no deaths. There was one postoperative pulmonary embolism, one myocardial infarct, and one type 2 endoleak. Mean operative time and blood loss were 4.67 hours and 217 mL, respectively. At a mean follow-up of 18 months, CT scans showed stable or shrinking aneurysm sacs. Conclusions In patients with contained ruptured AAAs who present with hemodynamic stability and comorbidities that preclude open surgery, commercially available endografts are a versatile treatment option even in the face of complicated aneurysm anatomy.

Original languageEnglish
Pages (from-to)154-160
Number of pages7
JournalJournal of Vascular Surgery
Volume40
Issue number1
DOIs
StatePublished - Jul 1 2004
Externally publishedYes

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Aortic Rupture
Abdominal Aortic Aneurysm
Hemodynamics
Aneurysm
Anatomy
Tomography
Endoleak
Therapeutics
United States Food and Drug Administration
Operative Time
Pulmonary Embolism
Abdominal Pain
Comorbidity
Rupture
Angiography
Emergencies
Myocardial Infarction
Equipment and Supplies

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

The utility of commercially available endografts in the treatment of contained ruptured abdominal aortic aneurysm with hemodynamic stability. / Lombardi, Joseph V.; Fairman, Ronald M.; Golden, Michael A.; Carpenter, Jeffrey P.; Mitchell, Marc; Barker, Clyde; McBride, Amy; Velazquez, Omaida C.

In: Journal of Vascular Surgery, Vol. 40, No. 1, 01.07.2004, p. 154-160.

Research output: Contribution to journalArticle

Lombardi, Joseph V. ; Fairman, Ronald M. ; Golden, Michael A. ; Carpenter, Jeffrey P. ; Mitchell, Marc ; Barker, Clyde ; McBride, Amy ; Velazquez, Omaida C. / The utility of commercially available endografts in the treatment of contained ruptured abdominal aortic aneurysm with hemodynamic stability. In: Journal of Vascular Surgery. 2004 ; Vol. 40, No. 1. pp. 154-160.
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