Emergency Treatment of Ruptured Abdominal Aneurysm

Abstract

Introduction: Abdominal aneurysm is considered a formidable pathological condition that requires prompt treatment. Its progressive increase leads to rupture and massive internal bleeding, which requires the most effective medical care. However, despite the improvement in medical equipment and postoperative care, mortality due to ruptured abdominal aneurysms is still close to 50%, which is primarily related to the severity of the pathology and open surgical intervention. Materials and Methods: 46 patients diagnosed with rupture of the abdominal aorta took part in the study. Selection criteria were a history of abdominal aortic rupture, conservative/operative treatment for the disease, and absence of other complications (acute renal failure, liver infarction) that could affect the results of the study. Results: Since January 2018, 46 cases of ruptured AAAs have been diagnosed. In all forty-six cases, surgical intervention was used: open surgery or endovascular technique. All 100% of patients had a previous history of diagnosed abdominal aortic aneurysm, for which they underwent periodic ultrasound examinations. As a result of the study, it was found that endovascular aortic aneurysm correction is the optimal method for both planned and emergency treatment of aortic aneurysm and its rupture. According to the Cochrane Specialized Register, it was established that endovascular repair is associated with a reduction in early morbidity and mortality after abdominal aneurysm, compared with other methods of surgical treatment. Furthermore, the study found that, unlike open surgery methods, endovascular techniques are associated with a lower risk of complications in the form of intestinal ischemia. Conclusions: Inferior quality studies and lack of information limit the conclusions of this review. From the statistical data shown in this paper, it can be concluded that there is a difference between endovascular and open methods of treatment of abdominal aortic aneurysm rupture. Mortality within the first 30 days after treatment and short-term complications are significantly lower in patients using EVAR. Systemic complications are also more prevalent in patients who were prescribed open surgical treatment.