PMID- 26027898
OWN - NLM
STAT- MEDLINE
DCOM- 20151116
LR  - 20151125
IS  - 1532-2165 (Electronic)
IS  - 1078-5884 (Linking)
VI  - 50
IP  - 3
DP  - 2015 Sep
TI  - Endovascular Treatment of Ruptured Abdominal Aortic Aneurysms with Hostile Aortic 
      Neck Anatomy.
PG  - 313-9
LID - S1078-5884(15)00259-2 [pii]
LID - 10.1016/j.ejvs.2015.04.017 [doi]
AB  - OBJECTIVE: To compare the mid-term results of endovascular aortic aneurysm repair 
      (EVAR) for ruptured abdominal aortic aneurysms (RAAAs) in patients with 
      favourable aortic neck anatomy (FNA) and hostile aortic neck anatomy (HNA). 
      METHODS: Patients treated for a RAAA in a high volume endovascular centre in the 
      Netherlands between February 2009 and January 2014 were identified 
      retrospectively and divided into two groups based on aortic neck anatomy, FNA and 
      HNA. HNA was defined as RAAA with a proximal neck of <10 mm, or a proximal neck 
      of 10-15 mm with a suprarenal angulation (alpha) >45 degrees  and/or an infrarenal angulation 
      (beta) >60 degrees , or a proximal neck of >15 mm combined with alpha >60 degrees  and/or beta >75 degrees . 
      Patient demographics, procedure details, 30 day and 1 year outcomes were 
      recorded. RESULTS: Of 39 included patients, 17 (44%) had HNA. Technical success 
      was 100% for FNA and 88% for HNA (p = .184). There were no type IA endoleaks on 
      completion angiography in either group; however, more adjunctive procedures were 
      necessary for intra-operative type IA endoleaks in the HNA group (24% vs. 0%, p = 
      .029). Thirty day mortality rates were comparable, FNA 14% vs. HNA 12% (p = 
      1.000). There were no statistically significant differences at 1 year follow up 
      in type I endoleaks, secondary endovascular procedures, or all cause mortality. 
      CONCLUSION: Emergency EVAR provides excellent results for treatment of RAAA 
      patients with both FNA and HNA. EVAR in RAAAs with HNA is technically feasible 
      and safe in experienced endovascular centres. Article history.
CI  - Copyright (c) 2015 European Society for Vascular Surgery. Published by Elsevier 
      Ltd. All rights reserved.
FAU - Broos, P P H L
AU  - Broos PP
AD  - Department of Vascular Surgery, Catharina Hospital, Eindhoven, The Netherlands; 
      Department of Epidemiology, CAPHRI Research School, Maastricht University, The 
      Netherlands.
FAU - 't Mannetje, Y W
AU  - 't Mannetje YW
AD  - Department of Vascular Surgery, Catharina Hospital, Eindhoven, The Netherlands; 
      Department of Epidemiology, CAPHRI Research School, Maastricht University, The 
      Netherlands.
FAU - Cuypers, Ph W M
AU  - Cuypers PW
AD  - Department of Vascular Surgery, Catharina Hospital, Eindhoven, The Netherlands.
FAU - van Sambeek, M R H M
AU  - van Sambeek MR
AD  - Department of Vascular Surgery, Catharina Hospital, Eindhoven, The Netherlands.
FAU - Teijink, J A W
AU  - Teijink JA
AD  - Department of Vascular Surgery, Catharina Hospital, Eindhoven, The Netherlands; 
      Department of Epidemiology, CAPHRI Research School, Maastricht University, The 
      Netherlands. Electronic address: joep.teijink@catharinaziekenhuis.nl.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20150528
PL  - England
TA  - Eur J Vasc Endovasc Surg
JT  - European journal of vascular and endovascular surgery : the official journal of 
      the European Society for Vascular Surgery
JID - 9512728
SB  - IM
CIN - Eur J Vasc Endovasc Surg. 2015 Oct;50(4):541. PMID: 26189606
CIN - Eur J Vasc Endovasc Surg. 2015 Oct;50(4):541-2. PMID: 26206207
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Aneurysm, Abdominal/diagnosis/mortality/*surgery
MH  - Aortic Rupture/diagnosis/mortality/*surgery
MH  - Aortography/methods
MH  - Blood Vessel Prosthesis Implantation/adverse effects/mortality
MH  - Endoleak/etiology
MH  - *Endovascular Procedures/adverse effects/mortality
MH  - Female
MH  - Hospitals, High-Volume
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
MH  - Netherlands
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Time Factors
MH  - Tomography, X-Ray Computed
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Abdominal aortic aneurysm
OT  - Aortic rupture
OT  - Vascular surgical procedures
EDAT- 2015/06/02 06:00
MHDA- 2015/11/17 06:00
CRDT- 2015/06/02 06:00
PHST- 2015/01/20 00:00 [received]
PHST- 2015/04/10 00:00 [accepted]
PHST- 2015/06/02 06:00 [entrez]
PHST- 2015/06/02 06:00 [pubmed]
PHST- 2015/11/17 06:00 [medline]
AID - S1078-5884(15)00259-2 [pii]
AID - 10.1016/j.ejvs.2015.04.017 [doi]
PST - ppublish
SO  - Eur J Vasc Endovasc Surg. 2015 Sep;50(3):313-9. doi: 10.1016/j.ejvs.2015.04.017. 
      Epub 2015 May 28.