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Symptomatic, nonruptured abdominal aortic aneurysms: are emergent operations necessary?
R A Cambria1, P Gloviczki, A W Stanson
1Division of Vascular Surgery, Mayo Clinic and Foundation, Rochester, Minn. 55905.
Annals of Vascular Surgery
|March 1, 1994
Summary
Emergency repair of symptomatic abdominal aortic aneurysms (AAAs) is linked to higher mortality. Delayed surgery for AAAs showed no deaths, suggesting a safer management strategy.
Area of Science:
- Vascular Surgery
- Aortic Aneurysm Management
- Surgical Outcomes
Background:
- Symptomatic, nonruptured abdominal aortic aneurysms (AAAs) present a management challenge.
- Evaluating morbidity and mortality is crucial for defining optimal AAA repair strategies.
Purpose of the Study:
- To assess the outcomes of surgical repair for symptomatic, nonruptured abdominal aortic aneurysms (AAAs).
- To determine the best management strategy for these patients.
Main Methods:
- Retrospective review of 36 patients undergoing AAA repair between 1987 and 1992.
- Analysis of patient demographics, aneurysm characteristics, surgical timing, complications, and mortality.
- Comparison with a matched control group of elective AAA repair patients.
Main Results:
- Symptomatic AAA patients had larger aneurysms and higher complication rates (66.7%) compared to elective repair.
- Emergency repair (< 4 hours) was significantly associated with increased 60-day mortality (p < 0.05).
- No deaths occurred in patients with delayed surgery; intensive care unit and hospital stays were longer for symptomatic cases.
Conclusions:
- Symptomatic abdominal aortic aneurysms (AAAs) are associated with increased morbidity and mortality.
- Delayed surgical intervention for symptomatic AAAs may be a safer management approach.
- Urgent repair of symptomatic AAAs carries significant risks, warranting careful consideration of surgical timing.