Endovascular Treatment of Ruptured Abdominal Aortic Aneurysms
Aortic aneurysms, especially when ruputured, constitute a direct life threat. Mortality in emergency surgical procedures has been estimated at 50 to 90%. In the recent years great advances have been achieved in the form of endovascular techniques, which offer effective treatment and are associated with a lower risk of complications and death.
The aim of the study was to evaluate endovascular treatment in patients with hypovolaemic shock due to aortic rupture in the infrarenal segment.
Material and methods. 19 patients with ruptured aortic aneurysms were treated by stentgraft implantation in our department from 2001 to 2006. Bifurcated stentgrafts were used in 6, while aortouniiliac stentgrafts were used in the remaining 13 with consecutive femoro-femoral by-pass grafting.
Results. Good results were obtained in 14 (73.7%) patients operated on while in hypovolaemic shock caused by aortic aneurysm rupture.
5 patients died in the perioperative period (26.3%). The deaths were caused by shock and multiple organ failure.
Conclusions. 1. Advances in vascular surgery offer an effective treatment for patients in hypovolaemic shock due to abdominal aortic aneurysm rupture. 2. New treatment modalities do not lift the surgeon's responsibility to manage shock, which remains the main cause of death in patients with ruptured aortic aneurysms. 3. If the technical conditions for stentgraft implantation are met, endovascular procedures should be the method of choice in cases of ruptured abdominal aortic aneurysm.