Document Type

Article

Publication Date

2015

College/Unit

School of Medicine

Department/Program/Center

Emergency Medicine

Abstract

Introduction: Traditionally, patients with suspected ruptured abdominal aortic aneurysm (rAAA) are taken immediately for operative repair. Computed tomography (CT) has been considered contraindicated. However, with the emergence of endovascular repair, this approach to suspected rAAA could be changing.

Methods: We present retrospective data in a case series of 110 patients with rAAA. Patients were managed at a single tertiary medical center over a five-year period. At this site, there was an established multidisciplinary protocol in which patients with suspected rAAA undergo CT with consideration for endovascular aortic repair (EVAR).

Results: Our results demonstrated a mortality of 30% with our institutional protocol for CT in suspected rAAA. Comparing patients who ultimately had EVAR with open repair, those able to have endovascular aneurysm repair (EVAR) had lower mortality, shorter hospital stays for survivors, and a greater likelihood of being discharged to home than those with open repair. While survivors were more likely to have had EVAR, surviving patients were younger, had a significantly lower creatinine at presentation, and required fewer blood transfusions than those who died.

Conclusion: Based on this case series, an institutional approach endorsing CT for presumed rAAA appears to be reasonable. Our results suggest that EVAR may be beneficial in appropriately-selected patients and that CT may potentially facilitate superior management options for patient care. [West J Emerg Med. 2015;16(3):367–371.]

Source Citation

Spencer, T., Juyia, R., Parks, R., & Hodapp, M. (2015). Case Series of Patients with Ruptured Abdominal Aortic Aneurysm. Western Journal of Emergency Medicine, 16(3), 367–371. https://doi.org/10.5811/westjem.2015.3.24027

Share

COinS
 
 

To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.