Endovascular Treatment and Open Repair of Ruptured Abdominal Aortic Aneurysms: Mortality Related to Abdominal Compartiment Syndrome

Solanich-Valldaura T, Giménez-Gaibar A, Navarro-Soto S, Cordoba N, Castro JG and Martinez-Toiran A

Department of Vascular Surgery, Hospital Universitari Parc Tauli, Sabadell, Spain
Department of Surgery, Hospital Universitari Parc Tauli, Sabadell, Spain

^*Correspondance to: Gimenez-Gaibar A 

 PDF  Full Text DOI: 10.25107/2474-1647.2292

Abstract

Ruptured Abdominal Aortic Aneurysm (RAAA) carries a high mortality rate of 32% to 80% in patients who survive surgery. Abdominal Compartment Syndrome (ACS) is an independent predictor of mortality in RAAA. The aim of the present study was to analyse 30-day survival in patients undergoing RAAA repair and the benefit of abdominal decompression in patients with ACS. This retrospective observational study included all patients undergoing Open Surgery (OS) or Endovascular Repair (REVAR) for RAAA between 2005 and 2015 in our centre. Demographic variables, type of surgery, delayed abdominal closure, pre-, intra- and postoperative ACS risk factors and 30-day survival were collected. A total of 61 patients were included: 39 open and 22 endovascular surgeries. Overall intra- and postoperative mortality was 54%. Mortality was higher in the OS group compared with REVAR. The postoperative results of the 43 patients who survived surgery were analysed. No differences were detected in postoperative mortality of RAAA according to the type of surgery. ACS did not appear to increase mortality in the OS group, but did increase it in the REVAR group. Differences were observed in 30-day survival depending on the type of abdominal closure (primary or delayed). The open abdomen showed better survival with OS than with REVAR. Consequently, in REVAR patients with ACS that require decompressive laparotomy, surgeons should consider evacuation of a space-occupying haematoma and opening the sac to ligate bleeding vessels within the aneurysm sac.

Keywords

Cite the article

Solanich-Valldaura T, Gimenez-Gaibar A, Navarro-Soto S, Cordoba N, Castro JG, Martinez-Toiran A. Endovascular Treatment and Open Repair of Ruptured Abdominal Aortic Aneurysms: Mortality Related to Abdominal Compartiment Syndrome. Clin Surg. 2019; 4: 2292.