PS22 Endovascular Repair of Ruptured Abdominal Aortic Aneurysm: Are Outcomes Improving?

Abstract

aneurismal arch involvement (n 1⁄4 3 [21%]), residual arch dissections after ascending aortic repair (n 1⁄4 2 [14%]), post-traumatic aneurysm (n 1⁄4 1 [7%]), and type II thoracoabdominal aortic aneurysm with arch involvement (n 1⁄4 1 [7%]). A total of 22 aortic arch vessels (brachiocephalic trunk, 7; left common carotid artery, 11; bovine arch, 2; left subclavian artery [LSA], 2) were targeted. The left LSA was intentionally covered in 12 cases and preoperatively revascularized in nine. Successful endograft implantation was achieved in all cases. Two early postoperative deaths occurred (one retroperitoneal hematoma and stroke, and one unclear cause). Further major complications included a major stroke with significant early clinical improvement, one delayed transient paraplegia, and one Vascular Plug dislocation. The mean intensive care unit and hospital stays were 36 2 and 116 8 days, respectively. At 8 6 7 months of follow-up, the cumulative survival was 79%, with no aneurysm-related death or reinterventions. One type II endoleak is managed conservatively and one patient with persistant false lumen perfusion is planned to undergo endograft extension. Conclusions: FBSG present a feasible and safe therapeutic alternative for repair of aortic arch pathologies in high-risk patients.