Anatomical suitability of ruptured abdominal aortic aneurysms for endovascular repair

• Published in: Journal of endovascular therapy Vol. 10; no. 3; p. 453
• Main Authors: Rose, Daniel F G, Davidson, Ian R, Hinchliffe, Robert J, Whitaker, Simon C, Gregson, Roger H, MacSweeney, Shane T, Hopkinson, Brian R
• Format: Journal Article
• Language: English
• Published: United States 01.06.2003
• Subjects: Aged; Aged, 80 and over; Angioplasty; Aortic Aneurysm, Abdominal - pathology; Aortic Aneurysm, Abdominal - surgery; Aortic Rupture - pathology; Aortic Rupture - surgery; Female; Humans; Male; Middle Aged
• ISSN: 1526-6028
• DOI: 10.1177/152660280301000309

To assess the anatomical suitability of ruptured abdominal aortic aneurysms (AAA) for emergency endovascular repair. All cases (46 patients [35 men; mean age 74 years, range 54-85]) in which computed tomographic angiography (CTA) confirmed AAA rupture over a 5-year period at our university hospital were reviewed for anatomical suitability for endovascular repair. Measurements were made by a radiologist experienced in anatomical assessment of CT criteria for elective endovascular aneurysm repair (EVAR). The mean aneurysm neck length was 18 mm (range 0-59); 17 were conical, 13 straight, 4 barrel, and 6 reverse conical. Six cases had no proximal neck. Overall, 37 (80%) patients were unsuitable for EVAR according to our criteria. Nearly half the patients (22, 48%) had > or =2 adverse features. Unsuitable neck morphology (35, 76%) was the primary reason for exclusion, but CIA aneurysm (10, 22%) and EIA tortuosity (7, 15%) were secondary adverse features. With current stent-graft design, the majority of ruptured abdominal aortic aneurysms are anatomically unsuitable for endovascular repair.