PMID- 25996842
OWN - NLM
STAT- MEDLINE
DCOM- 20170717
LR  - 20170914
IS  - 1827-191X (Electronic)
IS  - 0021-9509 (Linking)
VI  - 58
IP  - 5
DP  - 2017 Oct
TI  - Endovascular repair of ruptured abdominal aortic aneurysms with the endurant 
      stent-graft: a combined experience from three centers.
PG  - 643-649
LID - 10.23736/S0021-9509.16.08661-4 [doi]
AB  - BACKGROUND: Endovascular repair of ruptured abdominal aortic aneurysms (RAAAs) 
      has been previously reported to reduce mortality rates compared to open repair. 
      Newer stent-grafts may provide even better results with applicability in a larger 
      number of patients. We present our experience with the Medtronic Endurant 
      endograft over a three-year period. METHODS: Consecutive cases of RAAAs which 
      have been managed with the Endurant stent-graft were recruited from three centers 
      and were analyzed retrospectively. Twenty-three patients (22 males; mean age 74+/-9 
      years) were treated between June 2010 and May 2013. RESULTS: The technical 
      success rate was 100% with no intraoperative endoleaks. Thirty-day mortality was 
      13% (3/23 patients). Two patients required prolonged hospitalization and 
      mechanical ventilation. For the remaining 18 patients, the average 
      hospitalization length was 5.5 days. Two major risk factors were found to be 
      significantly associated with increased mortality: low systolic blood pressure on 
      arrival at the hospital (63+/-6 vs. 99+/-22; P=0.01), and post-operative development 
      of an abdominal compartment syndrome (Relative Risk - RR=13.3, 95% confidence 
      interval - CI: 1.6-106; P=0.03). Other important clinical variables which did not 
      significantly affect mortality included age (mean age 83+/-9 years in those who 
      died vs. 73+/-9 years in the survivors; P=0.09), type of graft (bifurcated vs. 
      aorto-uni-iliac; RR=2.2, 95% CI: 0.3-15; P=0.4), aneurysm diameter (11+/-4 cm vs. 
      9+/-2 cm; P=0.28), and proximal neck angulation (68+/-14 vs. 57+/-26 degrees; P=0.5). A 
      proximal neck angulation >75 degrees  was not associated with a higher mortality rate 
      (RR=1.33, 95% CI: 0.22-7.8; P=1). CONCLUSIONS: Endovascular repair of RAAAs 
      resulted in high technical success and low mortality rates in this series of 
      patients treated with the Endurant stent graft. Hypotension on arrival to the 
      hospital and development of an abdominal compartment syndrome were predictive of 
      increased risk of death. Patient age, aneurysm diameter and graft configuration 
      did not negatively impact survival. Non-compliance with the device instructions 
      for use (IFU) did not adversely affect results in this small patient series. 
      Larger studies are needed to confirm our results.
FAU - Papazoglou, Konstantinos
AU  - Papazoglou K
AD  - Department of Vascular Surgery, Hippokratio University Hospital, Thessaloniki, 
      Greece.
FAU - Mallios, Alexandros
AU  - Mallios A
AD  - Department of Vascular Surgery, Hippokratio University Hospital, Thessaloniki, 
      Greece - alexandrosmallios@gmail.com.
AD  - Department of Vascular Surgery, University of Oklahoma, Tulsa, OK, USA.
AD  - Department of Vascular Surgery, Mutualiste Montsouris Institute, Paris, France.
FAU - Buster, Bryan
AU  - Buster B
AD  - Department of Vascular Surgery, Agia Olga Hospital, Athens, Greece.
FAU - Antoniadis, Pavlos
AU  - Antoniadis P
AD  - Department of Vascular Surgery, Agia Olga Hospital, Athens, Greece.
FAU - Karkos, Christos
AU  - Karkos C
AD  - Department of Vascular Surgery, Hippokratio University Hospital, Thessaloniki, 
      Greece.
FAU - Staramos, Dimitris
AU  - Staramos D
AD  - Department of Vascular Surgery, Agia Olga Hospital, Athens, Greece.
FAU - Dervisis, Konstantinos
AU  - Dervisis K
AD  - Department of Vascular Surgery, Agia Olga Hospital, Athens, Greece.
FAU - Messiner, Ryan
AU  - Messiner R
AD  - Department of Vascular Surgery, University of Oklahoma, Tulsa, OK, USA.
FAU - Blebea, John
AU  - Blebea J
AD  - Department of Vascular Surgery, University of Oklahoma, Tulsa, OK, USA.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20150521
PL  - Italy
TA  - J Cardiovasc Surg (Torino)
JT  - The Journal of cardiovascular surgery
JID - 0066127
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Aneurysm, Abdominal/diagnostic imaging/mortality/physiopathology/*surgery
MH  - Aortic Rupture/diagnostic imaging/mortality/physiopathology/*surgery
MH  - Blood Pressure
MH  - *Blood Vessel Prosthesis
MH  - Blood Vessel Prosthesis Implantation/adverse effects/*instrumentation/mortality
MH  - Endovascular Procedures/adverse effects/*instrumentation/mortality
MH  - Female
MH  - Greece
MH  - Humans
MH  - Hypotension/mortality/physiopathology
MH  - Intra-Abdominal Hypertension/mortality/physiopathology
MH  - Length of Stay
MH  - Male
MH  - Middle Aged
MH  - Prosthesis Design
MH  - Retrospective Studies
MH  - Risk Factors
MH  - *Stents
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2015/05/23 06:00
MHDA- 2017/07/18 06:00
CRDT- 2015/05/22 06:00
PHST- 2015/05/23 06:00 [pubmed]
PHST- 2017/07/18 06:00 [medline]
PHST- 2015/05/22 06:00 [entrez]
AID - R37Y9999N00A150052 [pii]
AID - 10.23736/S0021-9509.16.08661-4 [doi]
PST - ppublish
SO  - J Cardiovasc Surg (Torino). 2017 Oct;58(5):643-649. doi: 
      10.23736/S0021-9509.16.08661-4. Epub 2015 May 21.