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Existing delays following the presentation of ruptured abdominal aortic aneurysm allow sufficient time to assess patients for endovascular repair

Existing delays following the presentation of ruptured abdominal aortic aneurysm allow sufficient time to assess patients for endovascular repair
Existing delays following the presentation of ruptured abdominal aortic aneurysm allow sufficient time to assess patients for endovascular repair
Objectives: The greatest benefit of endovascular AAA repair (EVAR) may be in the management of rupture (RAAA). However, the detailed anatomical assessment required for EVAR has lead to concerns of surgical delay and death during cross-sectional imaging. In this study, we prospectively assessed patients with RAAA and correlated time of hospital arrival with time of surgery or death to ascertain whether these concerns are justified.
Methods: All patients presenting with RAAA between October 2000 and December 2002 were included. The hospital arrival time, onset of surgery or time of death, were recorded, as were demographic and physiological parameters.
Results: One hundred consecutive patients were studied, median age 75 years (range 54–94). Seventy-nine patients underwent attempted conventional surgical repair and 21 were palliated. The median delay from arrival to operation was 159 min (range 16–1450 min). Mortality in the surgical group was not affected by the length of delay (p=1.0) or by CT scanning (p=0.34). The median time from arrival to death in the non-surgical group was 435 min (15 min–6 days).
Conclusions: Most patients who present with ruptured AAA experience a significant delay prior to surgery. This study suggests it is safe to assess the majority of RAAA patients for EVAR.
abdominal aortic aneurysm, rupture, temporal relationships
1078-5884
505-509
Boyle, J.R.
87ed0662-b71d-4527-91b5-da78d656b684
Gibbs, P.J.
d0349bae-fc4d-4860-9e75-06d9574c0d92
Kruger, A.
4f374925-4df7-4577-a992-953914ff970b
Shearman, C.P.
cf4d6317-f54d-4ab3-ba49-c6797897bbcf
Raptis, S.
145caa67-eb77-4e83-82d8-968b551839df
Phillips, M.J.
8ffbf284-ba63-4d65-97fa-eb6f256e8ade
Boyle, J.R.
87ed0662-b71d-4527-91b5-da78d656b684
Gibbs, P.J.
d0349bae-fc4d-4860-9e75-06d9574c0d92
Kruger, A.
4f374925-4df7-4577-a992-953914ff970b
Shearman, C.P.
cf4d6317-f54d-4ab3-ba49-c6797897bbcf
Raptis, S.
145caa67-eb77-4e83-82d8-968b551839df
Phillips, M.J.
8ffbf284-ba63-4d65-97fa-eb6f256e8ade

Boyle, J.R., Gibbs, P.J., Kruger, A., Shearman, C.P., Raptis, S. and Phillips, M.J. (2005) Existing delays following the presentation of ruptured abdominal aortic aneurysm allow sufficient time to assess patients for endovascular repair. European Journal of Vascular and Endovascular Surgery, 29 (5), 505-509. (doi:10.1016/j.ejvs.2005.01.027).

Record type: Article

Abstract

Objectives: The greatest benefit of endovascular AAA repair (EVAR) may be in the management of rupture (RAAA). However, the detailed anatomical assessment required for EVAR has lead to concerns of surgical delay and death during cross-sectional imaging. In this study, we prospectively assessed patients with RAAA and correlated time of hospital arrival with time of surgery or death to ascertain whether these concerns are justified.
Methods: All patients presenting with RAAA between October 2000 and December 2002 were included. The hospital arrival time, onset of surgery or time of death, were recorded, as were demographic and physiological parameters.
Results: One hundred consecutive patients were studied, median age 75 years (range 54–94). Seventy-nine patients underwent attempted conventional surgical repair and 21 were palliated. The median delay from arrival to operation was 159 min (range 16–1450 min). Mortality in the surgical group was not affected by the length of delay (p=1.0) or by CT scanning (p=0.34). The median time from arrival to death in the non-surgical group was 435 min (15 min–6 days).
Conclusions: Most patients who present with ruptured AAA experience a significant delay prior to surgery. This study suggests it is safe to assess the majority of RAAA patients for EVAR.

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Published date: 2005
Keywords: abdominal aortic aneurysm, rupture, temporal relationships

Identifiers

Local EPrints ID: 25275
URI: http://eprints.soton.ac.uk/id/eprint/25275
ISSN: 1078-5884
PURE UUID: d18cdfbd-80a0-472a-81af-7c4de07a1f0e

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Date deposited: 06 Apr 2006
Last modified: 15 Mar 2024 07:01

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Contributors

Author: J.R. Boyle
Author: P.J. Gibbs
Author: A. Kruger
Author: C.P. Shearman
Author: S. Raptis
Author: M.J. Phillips

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