PMID- 37685601
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230911
IS  - 2077-0383 (Print)
IS  - 2077-0383 (Electronic)
IS  - 2077-0383 (Linking)
VI  - 12
IP  - 17
DP  - 2023 Aug 25
TI  - The Management of Ruptured Abdominal Aortic Aneurysms: An Ongoing Challenge.
LID - 10.3390/jcm12175530 [doi]
LID - 5530
AB  - BACKGROUND: despite improvements in the diagnosis and treatment of elective AAAs, 
      ruptured abdominal aortic aneurysms (RAAAs) continue to cause a substantial 
      number of deaths. The choice between an open or endovascular approach remains a 
      challenge, as does postoperative complications in survivors. The aim of this 
      manuscript is to offer an overview of the contemporary management of RAAA 
      patients, with a focus on preoperative and intraoperative factors that could help 
      surgeons provide more appropriate treatment. METHODS: we performed a search on 
      MEDLINE, Embase, and Scopus from 1 January 1985 to 1 May 2023 and reviewed SVS 
      and ESVS guidelines. A total of 278 articles were screened, but only those with 
      data available on ruptured aneurysms' incidence and prevalence, preoperative 
      scores, and mortality rates after emergency endovascular or open repair for 
      ruptured AAA were included in the narrative synthesis. Articles were not 
      restricted due to the designs of the studies. RESULTS: the centralization of 
      RAAAs has improved outcomes after both surgical and endovascular repair. 
      Preoperative mortality risk scores and knowledge of intraoperative factors 
      influencing mortality could help surgeons with decision-making, although there is 
      still no consensus about the best treatment. Complications continue to be an 
      issue in patients surviving intervention. CONCLUSIONS: RAAA still represents a 
      life-threatening condition, with high mortality rates. Effective screening and 
      centralization matched with adequate preoperative risk-benefit assessment may 
      improve outcomes.
FAU - Troisi, Nicola
AU  - Troisi N
AUID- ORCID: 0000-0002-8779-9120
AD  - Vascular Surgery Unit, Department of Translational Research and New Technologies 
      in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy.
FAU - Bertagna, Giulia
AU  - Bertagna G
AUID- ORCID: 0000-0003-1363-489X
AD  - Vascular Surgery Unit, Department of Translational Research and New Technologies 
      in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy.
FAU - Torri, Lorenzo
AU  - Torri L
AUID- ORCID: 0000-0002-1587-2763
AD  - Vascular Surgery Unit, Department of Translational Research and New Technologies 
      in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy.
FAU - Canovaro, Francesco
AU  - Canovaro F
AUID- ORCID: 0000-0002-4499-8402
AD  - Vascular Surgery Unit, Department of Translational Research and New Technologies 
      in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy.
FAU - D'Oria, Mario
AU  - D'Oria M
AUID- ORCID: 0000-0002-7156-7827
AD  - Vascular Surgery Unit, Azienda Sanitaria Universitaria Giuliano Isontina, 34148 
      Trieste, Italy.
FAU - Adami, Daniele
AU  - Adami D
AD  - Vascular Surgery Unit, Department of Translational Research and New Technologies 
      in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy.
FAU - Berchiolli, Raffaella
AU  - Berchiolli R
AD  - Vascular Surgery Unit, Department of Translational Research and New Technologies 
      in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20230825
PL  - Switzerland
TA  - J Clin Med
JT  - Journal of clinical medicine
JID - 101606588
PMC - PMC10488063
OTO - NOTNLM
OT  - endovascular repair
OT  - high-volume center
OT  - open surgical repair
OT  - preoperative scores
OT  - ruptured abdominal aortic aneurysm
COIS- The authors declare no conflict of interest.
EDAT- 2023/09/09 11:42
MHDA- 2023/09/09 11:43
PMCR- 2023/08/25
CRDT- 2023/09/09 01:08
PHST- 2023/06/13 00:00 [received]
PHST- 2023/08/18 00:00 [revised]
PHST- 2023/08/23 00:00 [accepted]
PHST- 2023/09/09 11:43 [medline]
PHST- 2023/09/09 11:42 [pubmed]
PHST- 2023/09/09 01:08 [entrez]
PHST- 2023/08/25 00:00 [pmc-release]
AID - jcm12175530 [pii]
AID - jcm-12-05530 [pii]
AID - 10.3390/jcm12175530 [doi]
PST - epublish
SO  - J Clin Med. 2023 Aug 25;12(17):5530. doi: 10.3390/jcm12175530.