SELECTED ABSTRACTS FROM THE BSIR 2005 PROGRAMME

Excerpt

Purpose: Endovascular repair (EVR) of abdominal aortic aneurysm is increasingly used for both elective and emergency patients. We evaluated if a difference exists in baseline and rate of change of the aortic neck diameter between non-ruptured and ruptured AAA following EVR. Material and methods: Details of patients undergoing elective (Group 1) and emergency (Group 2) EVR between October 1998 and December 2004 were retrieved from the Endovascular Database of the Belfast City Hospital. Top neck diameters were recorded on the database prospectively from computerised tomographic scans. Measurements were taken pre-operatively and at 1, 3, 12, 24 months post-operatively. The rate of change of the aortic neck diameter (mm/month) was calculated for each group. Results: 146 elective and 36 emergency patients had EVR. 121 (92 male) elective and 26 (24 male) emergency patients were included in this analysis. Mean age was 75 years (± 6.5) in group 1, and 74 years (± 7.0) in group 2. Mean proximal aortic neck was larger pre-operatively in group 2 (25.0 ± 3.2 mm) in comparison to group 1 (23.3 ± 2.9 mm; p = 0.011). The growth rate of the top neck diameter was significantly greater at 12 months (p = 0.025) and 24 months (p = 0.0044) in group 2 compared to group 1. Conclusion: Aneurysm necks in patients with ruptured AAA are larger and dilate at a greater rate than those whose aneurysms are not ruptured. This increased expansion rate must be taken into consideration when oversizing the graft in emergency patients to allow adequate long-term exclusion of the aneurysm. …