PMID- 36072859
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220910
IS  - 2297-055X (Print)
IS  - 2297-055X (Electronic)
IS  - 2297-055X (Linking)
VI  - 9
DP  - 2022
TI  - Comparison between endovascular aneurysm repair-selected and endovascular 
      aneurysm repair-only strategies for the management of ruptured abdominal aortic 
      aneurysms: An 11-year experience at a Chinese tertiary hospital.
PG  - 870378
LID - 10.3389/fcvm.2022.870378 [doi]
LID - 870378
AB  - OBJECTIVES: The aim of this study was to review our management experience of 
      ruptured abdominal aortic aneurysms (RAAAs) using an endovascular aneurysm repair 
      (EVAR)-only strategy, and discuss the feasibility of this strategy. MATERIALS AND 
      METHODS: A retrospective analysis of clinical data was performed in patients with 
      RAAAs from January 2009 to October 2020. Our strategy toward operative treatment 
      for RAAAs evolved from an EVAR-selected (from January 2009 to April 2014) to an 
      EVAR-only (from May 2014 to October 2020) strategy. Baseline characteristics, 
      thirty-day mortality, perioperative complications, and long-term outcomes of 
      patients were compared between the two periods. RESULTS: A total of 93 patients 
      undergoing emergent RAAA repair were eventually included. The overall operation 
      rate in RAAAs at our centre was 70.5% (93/132). In the EVAR-only period, all 53 
      patients underwent ruptured endovascular aneurysm repair (rEVAR). However, only 
      47.5% (19/40) of patients in the EVAR-selected period underwent rEVAR, and the 
      remaining 21 patients underwent emergent open surgery. Thirty-day mortality in 
      the EVAR-only group was 22.6% (12/53) compared with 25.0% (10/40) for the 
      EVAR-selected group (P = 0.79). Systolic blood pressure </=70 mmHg [adjusted odds 
      ratio (OR) 4.99, 95% confidence interval (CI), 1.13-22.08, P = 0.03] and 
      abdominal compartment syndrome (adjusted OR 3.72, 95% CI, 1.12-12.32, P = 0.03) 
      were identified as independent risk factors responsible for 30-day mortality. 
      After 5 years, 47.5% (95% CI, 32.0-63.0%) of patients in the EVAR-selected group 
      were still alive versus 49.1% (95% CI, 32.3-65.9%) of patients in the EVAR-only 
      group (P = 0.29). CONCLUSION: The EVAR-only strategy has allowed rEVAR to be used 
      in nearly all the RAAAs with similar mortality comparing with the EVAR-selected 
      strategy. Due to the avoidance of operative modality selection, the EVAR-only 
      strategy was associated with a more simplified algorithm, less influence on 
      haemodynamics, and a shorter operation and recovery time.
CI  - Copyright (c) 2022 Fang, Yue, Shuai, Yuan, Ren, Fang, Pan, Liu, Dong and Fu.
FAU - Fang, Gang
AU  - Fang G
AD  - Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, 
      China.
AD  - Institute of Vascular Surgery, Fudan University, Shanghai, China.
AD  - National Clinical Research Center for Interventional Medicine, Shanghai, China.
FAU - Yue, Jianing
AU  - Yue J
AD  - Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, 
      China.
AD  - Institute of Vascular Surgery, Fudan University, Shanghai, China.
AD  - National Clinical Research Center for Interventional Medicine, Shanghai, China.
FAU - Shuai, Tao
AU  - Shuai T
AD  - Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, 
      China.
AD  - Institute of Vascular Surgery, Fudan University, Shanghai, China.
AD  - National Clinical Research Center for Interventional Medicine, Shanghai, China.
FAU - Yuan, Tong
AU  - Yuan T
AD  - Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, 
      China.
AD  - Institute of Vascular Surgery, Fudan University, Shanghai, China.
AD  - National Clinical Research Center for Interventional Medicine, Shanghai, China.
FAU - Ren, Bichen
AU  - Ren B
AD  - Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, 
      China.
AD  - Institute of Vascular Surgery, Fudan University, Shanghai, China.
AD  - National Clinical Research Center for Interventional Medicine, Shanghai, China.
FAU - Fang, Yuan
AU  - Fang Y
AD  - Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, 
      China.
AD  - Institute of Vascular Surgery, Fudan University, Shanghai, China.
AD  - National Clinical Research Center for Interventional Medicine, Shanghai, China.
FAU - Pan, Tianyue
AU  - Pan T
AD  - Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, 
      China.
AD  - Institute of Vascular Surgery, Fudan University, Shanghai, China.
AD  - National Clinical Research Center for Interventional Medicine, Shanghai, China.
FAU - Liu, Zhenjie
AU  - Liu Z
AD  - Department of Vascular Surgery, The Second Affiliated Hospital of Zhejiang 
      University, School of Medicine, Hangzhou, China.
FAU - Dong, Zhihui
AU  - Dong Z
AD  - Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, 
      China.
AD  - Institute of Vascular Surgery, Fudan University, Shanghai, China.
AD  - National Clinical Research Center for Interventional Medicine, Shanghai, China.
FAU - Fu, Weiguo
AU  - Fu W
AD  - Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, 
      China.
AD  - Institute of Vascular Surgery, Fudan University, Shanghai, China.
AD  - National Clinical Research Center for Interventional Medicine, Shanghai, China.
LA  - eng
PT  - Journal Article
DEP - 20220822
PL  - Switzerland
TA  - Front Cardiovasc Med
JT  - Frontiers in cardiovascular medicine
JID - 101653388
PMC - PMC9441666
OTO - NOTNLM
OT  - abdominal compartment syndrome
OT  - emergent aneurysm repair
OT  - ruptured abdominal aortic aneurysm
OT  - ruptured endovascular aneurysm repair
OT  - stent-graft
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2022/09/09 06:00
MHDA- 2022/09/09 06:01
PMCR- 2022/01/01
CRDT- 2022/09/08 02:34
PHST- 2022/02/06 00:00 [received]
PHST- 2022/08/04 00:00 [accepted]
PHST- 2022/09/08 02:34 [entrez]
PHST- 2022/09/09 06:00 [pubmed]
PHST- 2022/09/09 06:01 [medline]
PHST- 2022/01/01 00:00 [pmc-release]
AID - 10.3389/fcvm.2022.870378 [doi]
PST - epublish
SO  - Front Cardiovasc Med. 2022 Aug 22;9:870378. doi: 10.3389/fcvm.2022.870378. 
      eCollection 2022.