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Choice of treatment for the patient with urgent AAA: practical tips


Mayer, D; Rancic, Z; Pfammatter, T; Veith, F J; Lachat, M (2009). Choice of treatment for the patient with urgent AAA: practical tips. Journal of Cardiovascular Surgery, 50(5):595-598.

Abstract

Since the first successful attempts of emergency endovascular aneurysm repair (eEVAR) for patients with ruptured AAAs in the mid 1990s, surgeons have had to decide whether to treat patients by conventional open surgery or by minimally invasive but technically more demanding eEVAR. To date, selection of patients for eEVAR is still heavily debated and factors like hemodynamic instability, fear of treatment delay for patient transfer or imaging procedures and logistic issues often lead to the exclusion of anatomically suitable patients from eEVAR. However, these adverse factors may be overcome by adherence to an appropriate (intention-to-treat) protocol employing the use of a hypotensive hemostatic approach, transfemoral aortic balloon occlusion technique (when needed), different types of devices and an appropriate plan to resolve logistic issues, leaving anatomic suitability as the single most important determinant of suitability for EVAR.

Since the first successful attempts of emergency endovascular aneurysm repair (eEVAR) for patients with ruptured AAAs in the mid 1990s, surgeons have had to decide whether to treat patients by conventional open surgery or by minimally invasive but technically more demanding eEVAR. To date, selection of patients for eEVAR is still heavily debated and factors like hemodynamic instability, fear of treatment delay for patient transfer or imaging procedures and logistic issues often lead to the exclusion of anatomically suitable patients from eEVAR. However, these adverse factors may be overcome by adherence to an appropriate (intention-to-treat) protocol employing the use of a hypotensive hemostatic approach, transfemoral aortic balloon occlusion technique (when needed), different types of devices and an appropriate plan to resolve logistic issues, leaving anatomic suitability as the single most important determinant of suitability for EVAR.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Cardiovascular Surgery
04 Faculty of Medicine > University Hospital Zurich > Clinic for Diagnostic and Interventional Radiology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2009
Deposited On:07 Oct 2009 08:56
Last Modified:05 Apr 2016 13:22
Publisher:Edizioni Minerva Medica
ISSN:0021-9509
Additional Information:Full text article at http://www.minervamedica.it/en/journals/cardiovascular-surgery/article.php?cod=R37Y2009N05A0595
Free access at:Publisher DOI. An embargo period may apply.
Official URL:http://www.minervamedica.it/en/journals/cardiovascular-surgery/article.php?cod=R37Y2009N05A0595
PubMed ID:19741574
Permanent URL: http://doi.org/10.5167/uzh-21125

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