Ruptured aortic aneurysm has a surgical mortality
ranging from 50%-70%, one of the highest rates of all vascular emergencies [1-5].
Less invasive approaches to repair have been developed that could
potentially improve these statistics [1,5-7]. Endovascular aneurysm repair (EVAR)
is a minimally invasive approach that may be an alternative to open surgical
repair for select cases of ruptured aortic aneurysms [1,5]. Unfortunately,
the role of EVAR in patients with acute rupture of an abdominal aneurysm is
not clear, especially for patients that are hemodynamically unstable [1,8-10].
The literature is limited regarding use of
EVAR in this population of patients. We present a case of the successful
use of EVAR for an emergent repair in a hypotensive hemodynamically unstable
patient with an acutely ruptured abdominal aortic aneurysm (AAA).
Cite this paper
Basile, M. , Fiesseler, F. and Shih, R. (2013) Successful use of emergent endovascular aneurysm repair for a ruptured hypotensive abdominal aortic aneurysm. Case Reports in Clinical Medicine, 2, 135-137. doi: 10.4236/crcm.2013.22036.
 Moll, F.L., et al. (2011) Management of abdominal aortic aneurysms clinical practice guidelines of the european society for vascular surgery. European Journal of Vascular and Endovascular Surgery, 41, S1-S58.
 Bonardelli, S., et al. (2011) Open surgery in endovascular aneurysm repair era: Simplified classification in two risk groups owing to factors affecting mortality in 137 ruptured abdominal aortic aneurysms (RAAAs). Updates in Surgery, 63, 39-44. doi:10.1007/s13304-011-0053-z
 Katz, D.J., Stanley, J.C. and Zelenock, G.B. (1994) Operative mortality rates for intact and ruptured abdominal aortic aneurysms in Michigan: An eleven-year statewide experience. Journal of Vascular Surgery, 19, 804-817.
 Egorova, N., et al. (2008) National outcomes for the treatment of ruptured abdominal aortic aneurysm: Comparison of open versus endovascular repairs. Journal of Vascular Surgery, 48, 1092-100.
 Veith, F.J., et al. (2003) Treatment of ruptured abdominal aneurysms with stent grafts: A new gold standard? Seminars in Vascular Surgery, 16, 171-175.
 Larzon, T., Lindgren, R. and Norgren, L. (2005) Endovascular treatment of ruptured abdominal aortic aneurysms: A shift of the paradigm? Journal of Endovascular Therapy, 12, 548-555. doi:10.1583/04-1469.1
 Lyons, O.T.A., et al. (2010) Emergency endovascular aneurysm repair for ruptured abdominal aortic aneurysm: The way forward? Vascular, 18, 130-135.
 Karkos, C.D., et al. (2009) Mortality after endovascular repair of ruptured abdominal aortic aneurysms: A systematic review and meta-analysis. Archives of Surgery, 144, 770-778. doi:10.1001/archsurg.2009.132
 Azizzadeh, A., et al. (2008) Endovascular repair of ruptured abdominal aortic aneurysms: Systematic literature review. Vascular, 16, 219-224.
 Veith, F.J., et al. (2010) Is a randomized trial necessary to determine whether endovascular repair is the preferred management strategy in patients with ruptured abdominal aortic aneurysms? Journal of Vascular Surgery, 52, 1087-1093. doi:10.1016/j.jvs.2010.05.142
 Gerassimidis, T.S., et al. (2005) Endovascular management of ruptured abdominal aortic aneurysms: 6-year experience from a Greek center. Journal of Vascular Surgery, 42, 615-623. doi:10.1016/j.jvs.2005.05.061
 Franks, S., et al. (2006) Endovascular treatment of ruptured and symptomatic abdominal aortic aneurysms. European Journal of Vascular and Endovascular Surgery, 31, 345-350. doi:10.1016/j.ejvs.2005.08.037
 Hinchliffe, R.J., Braithwaite, B.D. and Hopkinson, B.R. (2003) The endovascular management of ruptured abdominal aortic aneurysms. European Journal of Vascular and Endovascular Surgery, 25, 191-201.
 Hinchliffe, R.J., et al. (2006) A randomised trial of endovascular and open surgery for ruptured abdominal aortic aneurysm—Results of a pilot study and lessons learned for future studies. European Journal of Vascular and Endovascular Surgery, 32, 506-515.
 Hinchliffe, R.J., et al. (2009) Endovascular repair of ruptured abdominal aortic aneurysm: A strategy in need of definitive evidence. Journal of Vascular Surgery, 49, 1077-1080. doi:10.1016/j.jvs.2009.02.005
 Veith, F.J., et al. (2009) Collected world and single center experience with endovascular treatment of ruptured abdominal aortic aneurysms. Annals of Surgery, 250, 1-7.
 Vaddineni, S.K., et al. (2005) Ruptured abdominal aortic aneurysm: A retrospective assessment of open versus endovascular repair. Annals of Vascular Surgery, 19, 782-786. doi:10.1007/s10016-005-7975-1
 Hinchliffe, R.J. and Braithwaite, B.D. (2007) Ruptured abdominal aortic aneurysm: Endovascular repair does not confer any long-term survival advantage over open repair. Vascular, 15, 191-196. doi:10.2310/6670.2007.00045
 Van Herzeele, I., et al. (2003) Endovascular repair of aortic rupture. European Journal of Vascular and Endovascular Surgery, 26, 311-316. doi:10.1053/ejvs.2002.2007
 Mehta, M., et al. (2006) Establishing a protocol for endovascular treatment of ruptured abdominal aortic aneurysms: Outcomes of a prospective analysis. Journal of Vascular Surgery, 44, 1-8. doi:10.1016/j.jvs.2006.02.057