Rupture of abdominal aortic aneurysms: A concurrent comparison of outcome of those occurring after endoluminal repair versus those occurring de novo

Aim: to compare the outcome of patients whose abdominal aortic aneurysm (AA A) ruptured following endoluminal repair with those whose AAA ruptured prio r to treatment. Patients: over a 4-year period 434 patients underwent treatment for AAA wit h conventional open (n = 253) and endoluminal repair (n = 181). Of those ha ving open repair, 216 patients had elective operations while 41 Iran operat ions for ruptured AAA. Four patients with ruptured AAA had undergone endolu minal repair previously (Group I) while the remaining 37 patients ruptured de novo (Group II). The patients in both groups were similar in age and sex but differed clinically. All four patients in Group I had major medical co -morbidities versus 56% in Group II (p<0.05). All patients in group I had a known endoleak following endoluminal repair. AII patients underwent open r epair. Results: the proportion of patients presenting with hypotension in Group I (1/4) was significantly less than in Group II (30/37). The difference in 30 -day mortality for Group I (0%) compared with that for Group II (43%) was s ignificant. The four patients in Group I remain alive and well at follow-up 22 months after operation. The outcome for Group I was better than Group I I despite the higher incidence of medical co-morbidities. Conclusion: endoluminal AAA repair complicated by a persistent endoleak doe s not protect from rupture, which may trot be accompanied by such major hae modynamic changes and high mortality as rupture de novo. Further long-term results in more patients are required to confirm this intermediate level of protection.