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Abstract

Purpose:

To compare the changes in aneurysm size following endovascular aneurysm repair (EVAR) for ruptured versus elective abdominal aortic aneurysms (AAA).

Methods:

Aneurysm sac diameter was measured from computed tomographic (CT) scans in 14 hemodynamically stable patients (14 men; mean age 74±7 years, range 60 to 83) prior to emergent stent-graft repair for ruptured AAA. The aneurysm diameter change was followed postprocedurally with serial CT and the outcomes compared to 74 AAA patients (58 men; mean age 74± 7 years, range 56 to 87) having elective EVAR in the same time period. The mean rate of sac decrease (mm/month) was calculated for each group.

Results:

There were 3 postoperative deaths in the ruptured AAA cohort, leaving 11 patients available for follow-up analysis (mean 16 months, range 2–49). Eight (73%) patients with ruptured AAA demonstrated significantly decreased (>5 mm) aneurysm diameters compared with 32 (43%) elective cases (p=0.07) followed a mean 20 months (range 3–51). The mean rate of sac diameter decrease was 1.50± 1.03 mm/month in the rupture group versus 0.73±0.86 mm/month in the elective group (p=0.04).

Conclusions:

This study suggests that ruptured AAAs treated with stent-graft experience sac regression at a higher rate compared with electively treated AAA. The reasons for these findings remain unclear.

Keywords

abdominal aortic aneurysm endovascular repair stent-graft aneurysm rupture aneurysm diameter sac diameter change

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Change in Aneurysm Diameter after Stent-Graft Repair of Ruptured Abdominal Aortic Aneurysms