PMID- 27421194
OWN - NLM
STAT- MEDLINE
DCOM- 20170123
LR  - 20171112
IS  - 1615-5947 (Electronic)
IS  - 0890-5096 (Linking)
VI  - 36
DP  - 2016 Oct
TI  - Endovascular Versus Open Repair for Ruptured Abdominal Aortic Aneurysms in a 
      Chinese Population.
PG  - 74-84
LID - S0890-5096(16)30468-X [pii]
LID - 10.1016/j.avsg.2016.03.006 [doi]
AB  - BACKGROUND: The aim of this study was to compare the perioperative outcomes and 
      midterm survival rate between open surgical repair (OSR) and endovascular 
      aneurysm repair (EVAR) of ruptured abdominal aortic aneurysms (RAAAs) in a 
      Chinese population. METHODS: A retrospective review was performed of the 
      demographic characteristics and perioperative outcomes from 59 RAAA patients 
      (mean 66.6 +/- 13.3 years of age; 49 men) undergoing OSR or EVAR at our center 
      between January 2003 and November 2014. The perioperative mortality and midterm 
      survival were assessed and compared between the OSR and EVAR groups. RESULTS: 
      Twenty-three patients underwent OSR, and 36 patients underwent EVAR. The overall 
      30-day mortality was 36.5% (47.8% OSR vs. 27.8% EVAR, P = 0.14). Total surgical 
      time, estimated blood loss, and blood transfusion in the OSR group were 
      significantly greater than those in the EVAR group (P < 0.001). Reintervention 
      within 30 days and during the follow-up was more frequent in the EVAR group 
      (36.1%) than in the OSR group (8.7%, P = 0.026). The mean follow-up was 
      38.2 +/- 29.3 months (range 6-100). A Kaplan-Meier survival curve analysis showed 
      no significant difference between the 2 groups (P = 0.079). The overall survival 
      rate at 1 year was 52.5% (31/59). Univariate and multivariate logistic regression 
      analyses demonstrated that free intraperitoneal rupture (odds ratio [OR] 0.143, 
      95% confidence interval [CI] 0.030-0.694, P = 0.016) and cardiovascular disease 
      (OR 0.072, 95% CI 0.006-0.898, P = 0.041) were independent risk factors for the 
      30-day mortality. Only intraperitoneal rupture was associated with the higher 
      midterm mortality (OR 4.852, 95% CI 1.046-22.499, P = 0.044). CONCLUSIONS: In an 
      experienced vascular center in China, although the 30-day mortality and midterm 
      survival of RAAAs were not significantly different between the EVAR and OSR 
      groups, EVAR has superior perioperative advantages. Consequently, EVAR is 
      recommended as the first-line treatment for anatomically suitable RAAA.
CI  - Copyright (c) 2016 Elsevier Inc. All rights reserved.
FAU - Guo, Baolei
AU  - Guo B
AD  - Department of Vascular Surgery, Zhongshan Hospital Fudan University, Shanghai, 
      China.
FAU - Dong, Zhihui
AU  - Dong Z
AD  - Department of Vascular Surgery, Zhongshan Hospital Fudan University, Shanghai, 
      China.
FAU - Fu, Weiguo
AU  - Fu W
AD  - Department of Vascular Surgery, Zhongshan Hospital Fudan University, Shanghai, 
      China. Electronic address: fu.weiguo@zs-hospital.sh.cn.
FAU - Guo, Daqiao
AU  - Guo D
AD  - Department of Vascular Surgery, Zhongshan Hospital Fudan University, Shanghai, 
      China.
FAU - Xu, Xin
AU  - Xu X
AD  - Department of Vascular Surgery, Zhongshan Hospital Fudan University, Shanghai, 
      China.
FAU - Chen, Bin
AU  - Chen B
AD  - Department of Vascular Surgery, Zhongshan Hospital Fudan University, Shanghai, 
      China.
FAU - Jiang, Junhao
AU  - Jiang J
AD  - Department of Vascular Surgery, Zhongshan Hospital Fudan University, Shanghai, 
      China.
FAU - Shi, Zhenyu
AU  - Shi Z
AD  - Department of Vascular Surgery, Zhongshan Hospital Fudan University, Shanghai, 
      China.
LA  - eng
PT  - Journal Article
DEP - 20160713
PL  - Netherlands
TA  - Ann Vasc Surg
JT  - Annals of vascular surgery
JID - 8703941
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Aneurysm, Abdominal/diagnostic imaging/mortality/*surgery
MH  - Aortic Rupture/diagnostic imaging/mortality/*surgery
MH  - Blood Loss, Surgical/prevention & control
MH  - Blood Transfusion
MH  - *Blood Vessel Prosthesis Implantation/adverse effects/mortality
MH  - China
MH  - Comorbidity
MH  - Computed Tomography Angiography
MH  - *Endovascular Procedures/adverse effects/mortality
MH  - Female
MH  - Hospital Mortality
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Odds Ratio
MH  - Operative Time
MH  - Patient Selection
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2016/07/17 06:00
MHDA- 2017/01/24 06:00
CRDT- 2016/07/17 06:00
PHST- 2015/10/16 00:00 [received]
PHST- 2016/02/26 00:00 [revised]
PHST- 2016/03/06 00:00 [accepted]
PHST- 2016/07/17 06:00 [pubmed]
PHST- 2017/01/24 06:00 [medline]
PHST- 2016/07/17 06:00 [entrez]
AID - S0890-5096(16)30468-X [pii]
AID - 10.1016/j.avsg.2016.03.006 [doi]
PST - ppublish
SO  - Ann Vasc Surg. 2016 Oct;36:74-84. doi: 10.1016/j.avsg.2016.03.006. Epub 2016 Jul 
      13.