PMID- 29778613
OWN - NLM
STAT- MEDLINE
DCOM- 20181211
LR  - 20181211
IS  - 1615-5947 (Electronic)
IS  - 0890-5096 (Linking)
VI  - 52
DP  - 2018 Oct
TI  - Endovascular Aneurysm Repair-First Strategy for Ruptured Aneurysm Focuses on 
      Fitzgerald Classification and Vein Thrombosis.
PG  - 36-40
LID - S0890-5096(18)30362-5 [pii]
LID - 10.1016/j.avsg.2018.03.023 [doi]
AB  - BACKGROUND: Recent study have demonstrated the good results of endovascular 
      aneurysm repair (EVAR) for ruptured abdominal aortic aneurysms (RAAAs). We report 
      on the results of our EVAR-first strategy for RAAAs focuses on Fitzgerald (F) 
      classification and vein thrombosis. MATERIALS AND METHODS: From 2011 to 2017, 31 
      patients with RAAA underwent EVAR at our hospital. We compared F-1 patients 
      (group A) with F-2 to F-4 patients with obvious retroperitoneal hematoma (group 
      B). RESULTS: The baseline characteristics in group A (n = 9) and group B (n = 22) 
      were similar. In group B, there were 8 cases of F-2, 10 cases of F-3, and 4 cases 
      of F-4. Of the 22 cases in group B, 16 (73%) cases involved preoperative shock. 
      Operation time was not significantly different (group A: 147 min and group B: 
      131 min, P = 0.48). The total mortality rate of group A and group B combined was 
      77.4%. The 30-day mortality was 0% for group A and 23.8% for group B, in which 
      there were 2 F-4 cases and 3 F-3 cases. In group B, hematoma-related 
      complications developed in 6 cases (deep vein thrombosis: 4 cases, abdominal 
      compartment syndrome: 1 case, and hematoma infection: 1 case), and 1 case with 
      deep vein thrombosis developed a pulmonary embolism that resulted in cardiac 
      arrest. The 3-year survival rate was significantly higher for group A (100% vs. 
      52.3%, P = 0.016), but the freedom from aortic death rate was not significantly 
      different (100% vs. 66.7%, P = 0.056). CONCLUSIONS: Using EVAR for RAAA is a 
      valid strategy. Certain complications that are associated with peritoneal 
      hematoma, especially venous thrombosis, should receive particular attention.
CI  - Copyright (c) 2018 Elsevier Inc. All rights reserved.
FAU - Murakami, Yuri
AU  - Murakami Y
AD  - Department of Surgery, Division of Vascular Surgery, The Jikei University Kashiwa 
      Hospital, Kashiwa-city, Chiba, Japan. Electronic address: yummmm66@gmail.com.
FAU - Toya, Naoki
AU  - Toya N
AD  - Department of Surgery, Division of Vascular Surgery, The Jikei University Kashiwa 
      Hospital, Kashiwa-city, Chiba, Japan.
FAU - Fukushima, Soichiro
AU  - Fukushima S
AD  - Department of Surgery, Division of Vascular Surgery, The Jikei University Kashiwa 
      Hospital, Kashiwa-city, Chiba, Japan.
FAU - Ito, Eisaku
AU  - Ito E
AD  - Department of Surgery, Division of Vascular Surgery, The Jikei University Kashiwa 
      Hospital, Kashiwa-city, Chiba, Japan.
FAU - Akiba, Tadashi
AU  - Akiba T
AD  - Department of Surgery, The Jikei University Kashiwa Hospital, Kashiwa-city, 
      Chiba, Japan.
FAU - Ohki, Takao
AU  - Ohki T
AD  - Department of Surgery, Division of Vascular Surgery, The Jikei University School 
      of Medicine, Tokyo, Japan.
LA  - eng
PT  - Journal Article
DEP - 20180518
PL  - Netherlands
TA  - Ann Vasc Surg
JT  - Annals of vascular surgery
JID - 8703941
SB  - IM
MH  - Aged
MH  - Aortic Aneurysm, Abdominal/complications/diagnostic imaging/mortality/*surgery
MH  - Aortic Rupture/complications/diagnostic imaging/mortality/*surgery
MH  - *Blood Vessel Prosthesis Implantation/adverse effects/mortality
MH  - *Endovascular Procedures/adverse effects/mortality
MH  - Female
MH  - Hematoma/etiology
MH  - Humans
MH  - Male
MH  - Retroperitoneal Space
MH  - Risk Factors
MH  - Treatment Outcome
MH  - Venous Thrombosis/diagnostic imaging/*etiology
EDAT- 2018/05/21 06:00
MHDA- 2018/12/12 06:00
CRDT- 2018/05/21 06:00
PHST- 2017/10/13 00:00 [received]
PHST- 2018/02/20 00:00 [revised]
PHST- 2018/03/10 00:00 [accepted]
PHST- 2018/05/21 06:00 [pubmed]
PHST- 2018/12/12 06:00 [medline]
PHST- 2018/05/21 06:00 [entrez]
AID - S0890-5096(18)30362-5 [pii]
AID - 10.1016/j.avsg.2018.03.023 [doi]
PST - ppublish
SO  - Ann Vasc Surg. 2018 Oct;52:36-40. doi: 10.1016/j.avsg.2018.03.023. Epub 2018 May 
      18.