Emergency aorto-iliac aneurysm surgery with low mortality and morbidity

A retrospective review of urgently operated aortic or iliac aneurysms over a 13 1/2 year period identified 51 patients (50 male, one female). In our consecutive series, 45 patients underwent an emergency operation for an abdominal aortic aneurysm (AAA) and six patients for an iliac aneurysm (IA). Mean age was 69 years. All patients had prominent symptoms: acute low abdominal pain or low back pain in 20 patients, shock in six patients, shock and pain in 25 patients. Free rupture was found in 28 cases, retroperitoneal rupture in 14 cases, fissurisation in seven and arterio-venous fistulisation in two cases. All reconstructions were done by the same vascular surgeon using Dacron prostheses. Intra-operative mortality rate was 3.9% (n = 2), 30-day mortality was 21.6% (n = 11) and cumulative hospital mortality was 23.5% (n = 12). The morbidity was 59%.