Comparison Of Open Versus Endovascular Repair For Ruptured Abdominal Aortic Aneurysms

Objective: To retrospectively analyze the clinical characteristics and treatment outcomes of patients with Ruptured abdominal aortic aneurysm(RAAA)admitted to Anhui Provincial Hos Pital between January,2010 and June,2022.To compare the short-term and long-term clinical outcomes of Endovascular aortic repair(EVAR)and Open surgical repair(OSR),analyze the advantages and disadvantages of the two surgical methods,and analyze the influencing factors of Patients with ruptured abdominal aortic aneurysm.It is of great significance to formulate the treatment strategy for ruptured abdominal aorta.Methods: The clinical data of 32 Patients with ruptured abdominal aortic aneurysm who were admitted to our hospital and underwent surgical treatment from January 1,2010 to June 1,2022 were retrospectively analyzed.Patients treated with endovascular repair techniques(endovascular intervention group,n=21)were compared with patients treated with conventional open surgery(open surgery group,n=11),intraoperative aneurysm morphology,type of anesthesia,operation time,intraoperative blood loss,intraoperative fluid infusion volume,blood transfusion volume,Postoperative complications,postoperative ICU stay time,total hospital stay,perioperative survival rate,and postoperative survival of the two groups were followed up.Results: A total of 32 patients were included in this study,and all patients underwent surgical treatment,including 21 patients in the endovascular technique group and 11 patients in the open surgery group.There were 27 males and 5 females.All the operations were successful.There were no significant differences in gender,age,preoperative mean arterial pressure,preoperative hypertension,diabetes,coronary heart disease,chronic renal insufficiency,peripheral vascular disease,malignant tumor,heart valve disease,smoking and drinking between the two groups(P>0.05).There were significant differences in age and aneurysm neck Angle between the two groups(P < 0.05).The 30-day mortality rate in EVAR group was significantly lower than that in OSR group(P<0.05).In terms of long-term survival rate,there was no significant difference between the two groups.There were no significant differences in perioperative complications between the two groups in cardiac complications,liver complications,renal complications,abdominal cavity syndrome,intestinal ischemia,lower limb ischemia,incision infection,endoleak complications,graft infection,pseudoaneurysm complications(P > 0.05).There were significant differences in pulmonary complications and DVT between the two groups,and the differences were statistically significant(P<0.05).In terms of influencing the 30-day mortality of patients with ruptured abdominal aortic aneurysm,preoperative circulatory stability,preoperative circulatory instability maintenance time,preoperative coronary heart disease,chronic renal insufficiency,peripheral vascular disease,and smoking were six factors affecting the 30-day mortality.logistic regression analysis showed that preoperative circulatory stability(P=0.045),the duration of preoperative circulatory instability(P=0.032)and preoperative coronary heart disease(P=0.039)were the risk factors for postoperative rupture of abdominal aortic aneurysm.Conclusion: 1.Compared with traditional open surgery,endovascular repair has the advantages of less surgical trauma,shorter operation time,less intrao Perative blood loss,lower30-day mortality rate,and faster recovery after surgery.2.In Patients with ruptured abdominal aortic aneurysm,maintaining hemodynamic balance is essential to prevent complications.Reducing the time of circulatory instability can effectively improve the Prognosis of Patients with ruptured abdominal aortic aneurysm.Preoperative coronary heart disease is a risk factor for the prognosis of patients with ruptured abdominal aortic aneurysm.