Emergency treatment of symptomatic or XXXX : the role of endovascular repair.

@entity1 @entity1755 @entity190 @entity397 @entity1028
PURPOSE: To report the initial experience with endovascular aortic repair (EVAR) in @entity1 with @entity397 or symptomatic @entity1028 ( @entity1028 ) and to compare the results with conventional open surgery. METHODS: Between May 1999 and December 2001, 24 @entity1 (21 @entity1 ; mean age 75 years, range 56-89) with @entity397 or symptomatic @entity1028 underwent EVAR using a specially designed aortomonoiliac endograft. Six @entity1 were selected based on device and operator availability; the subsequent 18 @entity1 were treated under a modified management protocol that offered stent-graft repair to all symptomatic @entity1028 @entity1 . The results of this new treatment protocol were analyzed on an intention-to-treat basis for the last 8 months of the study. The 30-day outcomes in all @entity1 treated with emergency EVAR were compared with 40 consecutive, contemporaneous @entity1 undergoing open surgery for symptomatic or @entity1755 . RESULTS: No early conversions to open surgery were performed. Significantly @entity190 and intensive care stay (p<0.05 for both) were observed in EVAR @entity1 . The mortality rate for EVAR @entity1 was 17% compared to 32% in conventionally treated @entity1 (NS). Among @entity1 with @entity1755 , the 30-day mortality rates were 24% (4/17) and 41% (12/29) for EVAR and open surgery, respectively (NS). Of 26 unselected @entity1 who were treated prospectively under the modified protocol, the majority (81%, 21/26) had anatomy suitable for endovascular repair; however, only 18 (69%) underwent EVAR owing to a short infrarenal neck (n=2) or device/operator unavailability (n=6). CONCLUSIONS: EVAR is a feasible treatment in the majority of @entity1 with @entity397 or symptomatic @entity1028 . The 30-day mortality appears to be similar between conventionally treated @entity1 and those undergoing endovascular repair.
