Clinical outcomes of infrarenal abdominal aortic aneurysms that underwent endovascular repair in a district general hospital

Abstract

Background: The purpose of this study was to compare the outcomes of elective endovascular abdominal aortic aneurysm repair (EVAR) and ruptured abdominal aortic aneurysm (rAAA) in patients at a district general hospital. Methods: A retrospective clinical study was conducted using data on 16 patients with elective abdominal aortic aneurysm (AAA) and nine patients with consecutive rAAA treated with EVAR from January 2010 to December 2014 in a district general hospital in Taiwan. Results: The preoperative characteristics of the two groups are listed. Thirty-six percent (9/25) of the patients were referred from other hospitals that did not offer surgical services. The percentage of patients with rAAA that were transferred from other hospitals was 55.5% (5/9). The stay durations in the intensive care unit for elective EVAR cases were shorter than those for emergent EVAR (1.75 +/- 1 d elective vs. 10 +/- 13.37 d emergent; P<0.019). The hospitalization days (11.06 +/- 4.07 d elective vs. 21.89 +/- 18.36 d emergent; P<0.031), operative time (183.63 +/- 57.24 min elective vs. 227.11 +/- 59.92 min emergent; P<0.009), and blood loss volumes (115.63 +/- 80.41 mL elective vs. 422.22 +/- 276.26 mL emergent; P<0.005) are shown; statistics for use of Perclose ProGlide (R) (7 cases elective vs. 0 case emergent; P<0.024) are compared. The overall 30-d mortality rate was 11.11% (1/9). Conclusions: The results confirm that EVAR surgery can be safely performed in a district general hospital with an integrated health care system. Using Perclose ProGlide (R) for selected cases may reduce blood loss and operative time.