Objective To explore the diagnostic methods, therapy and the prognostic factors for the ruptured abdominal aortic aneurysm (RAAA). Methods The clinical data of 23 patients (males 15, females 8, age range 35-78, mean age 65) with RAAA below the level of renal arteries, who were treated with surgery, were collected from April 1999 to December 2005 and were analyzed retrospectively. Seven cases had a history of RAAA, 6 cases had pulsating abdominal masses; 15 cases were diagnosed by emergency Doppler ultrasonic examination or CT. All of the patients underwent emergency surgical operation: The ruptures of the abdominal aorta below the level of renal arteries were obstructed by using clamp ring or using transluminal ballon according to conditions of each patient. The aritficial vascular graft was then taken after the control of hemorrhage. Results There were 9 (39%) patients died within 30 d after the emergency operation. The causes of death included acute renal failure because of hemorrhagic shock (4 cases), multiple organ failure (3 cases), and respiratory-circulatory failure (2 cases).Conclusion Surgery may be an effective treatment for RAAA. The critical step of the operation was to control hemorrhage by obstructing the proximal end of the aortic rupture according to the conditions of each patient. The main postoperative complications and causes of death include acute cardiovascular and cerebrovascular diseases, renal failure and pneumonia.
ObjectiveTo evaluate clinical outcomes of thoracic endovascular aortic repair (TEVAR)for the treatment of Stanford type B aortic dissection (AD)and descending aortic aneurysm. MethodsClinical data of 20 patients with Stanford type B AD or descending aortic aneurysm who underwent TEVAR in West China Hospital from March to June 2013 were retrospectively analyzed. There were 19 male and 1 female patients with their age of 41-76 (58.3±10.2)years. Clinical outcomes were analyzed. ResultsAmong the 20 patients, 18 patients were successfully discharged, 1 patient refused further postoperative treatment and was discharged, and 1 patient died postoperatively. Sixteen patients (88.9%)were followed up for over 3 months. In all the patients during follow-up, true lumen diameter recovered within the scope of intravascular stents, and there was thrombosis in false lumen or aneurysm lumen. ConclusionTEVAR provides a new choice with significant advantages for the treatment of Stanford type B AD, especially for the elderly and patients with concomitant serious diseases, so it is worthy of clinical application.