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Survival rate higher with endovascular repair for patients with ruptured abdominal aortic aneurysm

Issue: March 2013

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Patients with ruptured abdominal aortic aneurysms are more likely to survive when treated with minimally invasive repair compared with open surgical repair, according to results of a 10-year study presented at the 25th Annual International Symposium on Endovascular Therapy.

Sherif Sultan, MB, MD, an endovascular surgeon at University College Hospital Galway, Ireland, and colleagues monitored 106 patients with ruptured abdominal aortic aneurysms (AAA). Seventy-five patients underwent open surgery (mean age, 72.9 years) and 31 underwent minimally invasive endovascular aneurysm repair (mean age, 71.2 years) between 2002 and 2012.

The 30-day aneurysm survival rate was 70% for patients who had endovascular aneurysm repair vs. 33% for patients who had open surgery (P=.0001). According to the researchers, all-cause mortality was not significant (P=.099); however, patients who underwent open surgery had higher overall mortality (68% vs. 31%; P<.001). In the entire group, results of aneurysm-related mortality were 12.5% after week 1, 25% after 1 month, 37.5% after 6 months, 50% after 1 year and 90% after 5 years. At 5 years, patients, patients in the endovascular aneurysm repair group had an overall mortality survival rate of 75%.

In other results, the open surgery group had a higher incidence of postoperative major adverse cardiac events (P=.0001). Hypertension and smoking were associated with increases in ruptured AAA; however, there was no association between diabetes and ruptured AAAs.

“Many of these [ruptured AAA] patients are frail, with a variety of health issues, and a minimally invasive solution is by far the best option,” Sultan wrote in a press release. “We found 85% of patients are suitable for minimally invasive aneurysm repair and, in those patients, endovascular aneurysm repair should always be the first option.”

For more information:

Sultan S. Poster #17. Presented at: 25th Annual International Symposium on Endovascular Therapy (ISET); Jan. 19-23, 2013; Miami, Fla.