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Background: Endovascular repair of ruptured abdominal aortic aneurysms (RAAA) has emerged as an alternative to open repair with improved early survival, but its durability is unclear. Identifying a cohort of patients with good early survival after open repair could provide a more durable option.
Methods: We conducted a retrospective review of all patients discharged from our institution with the diagnosis of RAAA between 1998-2008. Demographic, clinical and operative factors were analyzed with a primary endpoint of in-hospital mortality. Patients were then categorized by age greater and less than 70 years for comparison.
Results: We identified 52 patients with ruptured abdominal aortic aneurysm who underwent open repair with an overall in-hospital survival of 52%. The 14 patients <70 years old had a significantly better survival when compared to the 38 patients >70 years old (78.6% vs. 42.1% p=0.017). At the time of presentation, the younger patients were more hemodynamically stable (Systolic blood pressure 112mmHg vs 91mmHg p=0.03), had fewer known aneurysms (14% vs 42% p=0.047), had more preoperative imaging (71.2% vs 63.2% p=0.003) and had larger aneurysms (8.9cm vs 7.3cm p=0.008) when compared to the older group. Additionally, younger patients had bifurcated graft reconstruction more frequently (50% vs 18.5% p=0.008).
Conclusion: Even in the era of endovascular repair of RAAA, a more durable repair with open technique may be beneficial for a select cohort of patients.