Fast-track protocol of endovascular aneurysm repair for ruptured abdominal aortic aneurysm
10.3760/cma.j.cn115455-20210415-00524
- VernacularTitle:破裂性腹主动脉瘤的快速通道腔内修复治疗研究
- Author:
Shuqiang DONG
1
;
Penglu XIE
;
Wenfeng CAO
;
Zhaoyu ZHANG
;
Kai YANG
;
Yu ZHANG
;
Tao HAO
;
Sida LIU
Author Information
1. 解放军联勤保障部队第九四〇医院心血管外科，兰州 730050
- Keywords:
Aortic aneurysm, abdominal;
Endovascular aneurysm repair;
Ruptured;
Fast track
- From:
Chinese Journal of Postgraduates of Medicine
2023;46(1):35-39
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the effective and safety of endovascular aneurysm repair (EVAR) for ruptured abdominal aortic aneurysm (RAAA) at one tertiary center, and to improve the outcomes of RAAA under fast-track protocol.Methods:Nineteen cases of RAAA in the 940th Hospital of Joint Logistic Support Force of PLA from January 2014 to December 2020 were reviewed retrospectively. EVAR-fist strategy was employed from the emergency room to the operating room by using fast-track protocol. Preoperative management, anatomic characteristics, choice of anesthesia, operative procedures and postoperative complications were collected and analyzed. Abdominal compartment syndrome (ACS) and hospital mortality were paid special attention.Results:Nineteen cases were undergone EVAR procedures. The age was (73.4 ± 7.4) years old, and the AAA size was (67.8 ± 13.6) mm. Two cases underwent cardiopulmonary resuscitation at emergency department. General anesthesia was used in 13 patients and local anaesthesia in 6 patients. Successful stent graft deployment was achieved in all cases. The duration from emergency room to operating room was (84.8 ± 22.4) min. The hospital stay time was (9.7 ± 5.7) d. The hospital mortality was 5/19. The 5 deaths were reviewed: 3 died for multiple organ failure, 1 for irreversible shock, and 1 for ongoing bleeding.Conclusions:Excellent results were confirmed by using EVAR-first strategy for RAAA. The management of hemodynamically unstable state, standardized endovascular procedure, fast-track program and multidiscipline team collaboration were the very important determining factors for the implementation of EVAR. Focused efforts to reduce RAAA mortality are warranted.
