ISSN 1016-5169 | E-ISSN 1308-4488
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Endovascular Repair of Ruptured Aortic Aneurysm: A Single-Center Experience [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2024; 52(2): 88-95 | DOI: 10.5543/tkda.2023.91628

Endovascular Repair of Ruptured Aortic Aneurysm: A Single-Center Experience

Uygar Çağdaş Yüksel1, Serkan Asil1, Erkan Yıldırım1, Mehmet Sadık Karpat1, Suat Görmel1, Serdar Fırtına1, Salim Yaşar1, Barış Buğan1, Ayşe Saatçi Yaşar1, Murat Çelik1, Cengiz Bolcal2, Cem Barçın1
1Department of Cardiology, Gülhane Training and Research Hospital, Ankara, Türkiye
2Department of Cardiovascular Surgery, Gülhane Training and Research Hospital, Ankara, Türkiye


OBJECTIVE
Aortic rupture is a rare and catastrophic emergency. Prompt diagnosis and treatment are the primary determinants of mortality. During follow-up, the majority of patients who have been effectively treated die from hypovolemic shock and multiorgan failure. This article describes the clinical and procedural details of sixteen patients with ruptured aortic aneurysms treated endovascularly. In addition, it discusses the main factors contributing to the mortality of these patients.


METHOD
Patients who underwent endovascular treatment for acute aortic rupture at our center from October 2016 to March 2023 were included in this retrospective study.


RESULTS
A total of 16 patients underwent endovascular aneurysm repair (EVAR) or thoracic endovascular aneurysm repair (TEVAR) for acute aortic rupture. The patients’ mean age was 73.06 years (range: 52-92), and 15 of them were male. The ruptures occurred in the abdominal aortic aneurysm in ten patients, in thoracic aortic aneurysm in three patients, in the isolated iliac artery aneurysm in two patients, and there was one case of non-aneurysmal aortic rupture. In our series, patients who presented with an impending, self-limited rupture and stable hemodynamic status had good prognostic outcomes. However, eight patients died due to multiorgan failure, hemorrhagic shock, disseminated intravascular coagulopathy, renal failure, or abdominal compartment syndrome. These patients generally had poor admission vital signs and low hemoglobin values. The most critical determinants for the success of the procedure are promptly stopping the bleeding, avoiding general anesthesia, and opting for blood product replacement instead of fluid replacement.


CONCLUSION
Each patient with ruptured aortic aneurysm should be managed according to the patient’s hemodynamics at presentation, the size of the aneurysm, the suitability for percutaneous procedure, logistical factors, and the operator-center’s experience.

Keywords: Aortic aneurysm rupture, aortic rupture, endovascular aortic repair

How to cite this article
Uygar Çağdaş Yüksel, Serkan Asil, Erkan Yıldırım, Mehmet Sadık Karpat, Suat Görmel, Serdar Fırtına, Salim Yaşar, Barış Buğan, Ayşe Saatçi Yaşar, Murat Çelik, Cengiz Bolcal, Cem Barçın. Endovascular Repair of Ruptured Aortic Aneurysm: A Single-Center Experience. Turk Kardiyol Dern Ars. 2024; 52(2): 88-95

Corresponding Author: Serkan Asil, Türkiye
Manuscript Language: English


Journal Metrics

Journal Citation Indicator: 0.18
CiteScore: 1.1
Source Normalized Impact
per Paper:
0.22
SCImago Journal Rank: 0.348

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