PMID- 19687383
OWN - NLM
STAT- MEDLINE
DCOM- 20090915
LR  - 20181201
IS  - 1538-3644 (Electronic)
IS  - 0004-0010 (Linking)
VI  - 144
IP  - 8
DP  - 2009 Aug
TI  - Mortality after endovascular repair of ruptured abdominal aortic aneurysms: a 
      systematic review and meta-analysis.
PG  - 770-8
LID - 10.1001/archsurg.2009.132 [doi]
AB  - OBJECTIVE: To document mortality after endovascular repair of ruptured abdominal 
      aortic aneurysms (RAAAs). DATA SOURCES: MEDLINE and EMBASE databases. STUDY 
      SELECTION: Articles that reported data on mortality after endovascular repair of 
      RAAAs were identified. Only patients with true ruptures were included. 
      Additionally, information on mortality after concurrent open repair was sought. 
      DATA EXTRACTION: One of the authors reviewed all of the studies and extracted 
      appropriate data. A total of 43 articles were identified, 14 of which were 
      excluded. DATA SYNTHESIS: Twenty-nine articles with 897 patients who underwent 
      endovascular repair met the inclusion criteria. Of the patients with available 
      information, 86% were men; 29% had been operated on under local anesthesia; 28% 
      were hemodynamically unstable; 17% required intra-aortic balloon occlusion; 48% 
      received bifurcated stent grafts; 6% had endovascular procedures converted to 
      open repair intraoperatively; and 5.5% developed abdominal compartment syndrome. 
      In-hospital and/or 30-day mortality ranged between 0% and 54% in different 
      series, whereas the pooled mortality after endovascular repair was 24.5% (95% 
      confidence interval [CI], 19.8%-29.4%). In 19 studies reporting results of both 
      endovascular and concurrent open repair from the same unit, the pooled mortality 
      after open repair was 44.4% (95% CI, 40.0%-48.8%), and the pooled overall 
      mortality for RAAA undergoing endovascular or open repair was 35% (95% CI, 
      30%-41%). CONCLUSIONS: Endovascular repair of RAAAs is associated with acceptable 
      mortality rates. Additional studies will be required to verify these promising 
      results and precisely define the role of endovascular treatment as an additional 
      therapeutic option for RAAAs.
FAU - Karkos, Christos D
AU  - Karkos CD
AD  - 5th Department of Surgery, Medical School, Aristotle University of Thessaloniki, 
      Hippocrateio Hospital, Konstantinoupoleos 49, Thessaloniki 546 42, Greece. 
      ckarkos@hotmail.com
FAU - Harkin, Denis W
AU  - Harkin DW
FAU - Giannakou, Andry
AU  - Giannakou A
FAU - Gerassimidis, Thomas S
AU  - Gerassimidis TS
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
PL  - United States
TA  - Arch Surg
JT  - Archives of surgery (Chicago, Ill. : 1960)
JID - 9716528
SB  - IM
MH  - Aneurysm, Ruptured/*mortality/*surgery
MH  - Aortic Aneurysm, Abdominal/*mortality/*surgery
MH  - Blood Vessel Prosthesis Implantation/*methods
MH  - Humans
RF  - 64
EDAT- 2009/08/19 09:00
MHDA- 2009/09/16 06:00
CRDT- 2009/08/19 09:00
PHST- 2009/08/19 09:00 [entrez]
PHST- 2009/08/19 09:00 [pubmed]
PHST- 2009/09/16 06:00 [medline]
AID - 144/8/770 [pii]
AID - 10.1001/archsurg.2009.132 [doi]
PST - ppublish
SO  - Arch Surg. 2009 Aug;144(8):770-8. doi: 10.1001/archsurg.2009.132.