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Emergency operation in patients with symptomatic abdominal aortic aneurysms
R W Buss1, G P Clagett, D F Fisher
1Department of Surgery, University of Texas Southwestern Medical Center, Dallas 75235-9031.
American Journal of Surgery
|December 1, 1988
Summary
Routine preoperative CT scans are not needed for symptomatic abdominal aortic aneurysms. This study found no improved outcomes, and CT scans may delay critical emergency surgery for ruptured aneurysms.
Area of Science:
- Vascular Surgery
- Diagnostic Imaging
Background:
- Acutely symptomatic abdominal aortic aneurysms (AAAs) present a surgical emergency.
- The role of routine preoperative computerized tomography (CT) scanning in evaluating these patients remains debated.
Purpose of the Study:
- To determine if routine preoperative CT scanning is necessary for patients with symptomatic AAAs.
- To assess the impact of CT on patient outcomes and surgical decision-making.
Main Methods:
- Retrospective review of patients presenting with symptomatic AAAs over a 5-year period.
- All patients underwent emergency surgery without preoperative CT scans.
- Mortality rates were compared between groups: symptomatic intact AAA, asymptomatic elective AAA, and ruptured AAA.
Main Results:
- Mortality for symptomatic intact AAA emergency repair was 3%.
- Mortality for asymptomatic AAA elective repair was 5%.
- Mortality for ruptured AAA was significantly higher at 68%.
Conclusions:
- Preoperative CT scanning did not improve outcomes in this cohort of symptomatic AAA patients.
- Routine CT scanning is rarely indicated due to cost and potential delays in emergency surgery for ruptured aneurysms.