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Master Thesis

Évaluation monocentrique du traitement des anévrysmes rompus de l'aorte abdominale sous-rénale par technique endovasculaire

Abstract : Objective: The aim of this study was to evaluate the short-term results of endovascular treatment of infrarenal ruptured abdominal aortic aneurysm (RAAA) repair in terms of morbidity and mortality. Materials and Methods: From January 2010 to May 2015, patients admitted to the intensive care at Bordeaux’s CHU, having a diagnosis for RAAA and entering the operating room for endovascular surgery, were included retrospectively. The primary outcome was mortality at day 30, the secondary endpoints were morbidity and rate of technical success. Results: Of the 76 RAAA arrived alive at the hospital, 38 patients (31 men and 7 women), mean age 74.7 years, were treated with endovascular surgery. 61% were classified ASA 3. 5 RAAA were secondary to an endoleak stentgraft, 1 RAAA realized aorto-intestinal fistula. The feasibility of endovascular treatment was 43%. 13 patients (34%) unstable had a lower systolic blood pressure less than 80 mmH! g requiring intraoperative endoclampage in 3 patients (8%). Endovascular assemblies consisted of a aorto-mono-iliac and aorto-bi-iliac stentgraft in 39 and 47% of cases respectively; in the event of RAAA of endoleaks, aortic proximal extension and a leg extension was necessary in 5% of each cases. Open renal chimney was associated for 2 patients. 2 procedures are complicated to surgical conversion. One month after, the mortality rate was 21%, the overall morbidity rate was 71%, rates of primary and secondary technical success were 66 and 84% respectively. The primary endoleak rate of type I, II and III respectively were 16, 18 and 5%. Conclusion: These results are comparable to those in the literature. A long-term evaluation is needed to determine the safety and effectiveness of endovascular treatment in an emergency.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01244386
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Tuesday, December 15, 2015 - 4:34:21 PM
Last modification on : Wednesday, August 23, 2017 - 4:33:19 PM
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Charlotte Gonthier. Évaluation monocentrique du traitement des anévrysmes rompus de l'aorte abdominale sous-rénale par technique endovasculaire. Médecine humaine et pathologie. 2015. ⟨dumas-01244386⟩

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