Essay on Abdominal Aortic Aneurysm

Raptured abdominal aorta aneurysm is still one of the most common vascular emergencies even though mortality from the condition keeps declining. Without repair, the abdominal aorta aneurysm is almost always fatal (Nordon et al., 2011). The conventional method of treatment and management of ruptured abdominal aorta aneurysm is open repair (Khan et al., 2016). This is done through retroperitoneal or transperitoneal incisions (Foley & Fox, 2017). It involves first obtaining the distal and proximal aorta controls, the aneurysm is then opened, and the back-bleeding arteries branch is litigated (Nordon et al., 2011). The prosthetic graft is then sutured from the normal proximal aorta to the normal distal aorta. Once the regular blood flow is restored to the bilateral arteries, the aneurysm sac is closed (Reimerink et al., 2013).

The approach is linked to some benefits, and that is why it is the standard approach for dealing with abdominal aorta aneurysm. Most of these benefits are physiologically related and include a reduction in cardiac stress, fluid losses, the severity of ileus, and postoperative pulmonary complications (Lederle et al., 2012). In the absence of substantial disease of the iliac arteries, straight tube grafts are typically recommended (Patel et al., 2016). The technique also allows for re-implantation of the patent inferior mesenteric artery in cases of increased risks of ischemia (Keisler & Carter, 2015).

This open repair is durable and practical. Research indicates that seventy-five percent of the patients treated through the approach has had five years survival rates (Reimerink et al., 2013). Complications of the approach include pulmonary and cardiac events, graft infection and wound development (Raux et al., 2014). The recorded mortality associated with the open repair is approximated at two percent (Kent, 2014). There is thus ninety-eight percent survival rate using the approach (Reimerink et al., 2013). The patient has close to a hundred percent recovery rate.

Reference list

Foley, L.S. and Fox, C.J., 2017. Abdominal aortic aneurysm. Abernathy's Surgical Secrets E-Book, p.349.

IMPROVE Trial Investigators, 2014. Endovascular or open repair strategy for ruptured abdominal aortic aneurysm: 30 day outcomes from IMPROVE randomised trial. Bmj, 348, p.f7661.

Keisler, B. and Carter, C., 2015. Abdominal aortic aneurysm. American family physician, 91(8).

Kent, K.C., 2014. Abdominal aortic aneurysms. New England Journal of Medicine, 371(22), pp.2101-2108.

Khan, S., Lombardi, J.V., Carpenter, J.P., Trani, J., Alexander, J.B. and Caputo, F.J., 2016. Open abdominal aortic aneurysm repair is still necessary in an era of advanced endovascular repair. Journal of vascular surgery, 64(2), pp.333-337.

Lederle, F.A., Freischlag, J.A., Kyriakides, T.C., Matsumura, J.S., Padberg Jr, F.T., Kohler, T.R., Kougias, P., Jean-Claude, J.M., Cikrit, D.F. and Swanson, K.M., 2012. Long-term comparison of endovascular and open repair of abdominal aortic aneurysm. New England Journal of Medicine, 367(21), pp.1988-1997

Nordon, I.M., Hinchliffe, R.J., Loftus, I.M. and Thompson, M.M., 2011. Pathophysiology and epidemiology of abdominal aortic aneurysms. Nature reviews cardiology, 8(2), pp.92-102.

Patel, R., Sweeting, M.J., Powell, J.T., Greenhalgh, R.M. and EVAR trial investigators, 2016. Endovascular versus open repair of abdominal aortic aneurysm in 15-years' follow-up of the UK endovascular aneurysm repair trial 1 (EVAR trial 1): a randomised controlled trial. The Lancet, 388(10058), pp.2366-2374.

Raux, M., Patel, V.I., Cochennec, F., Mukhopadhyay, S., Desgranges, P., Cambria, R.P., Becquemin, J.P. and LaMuraglia, G.M., 2014. A propensity-matched comparison of outcomes for fenestrated endovascular aneurysm repair and open surgical repair of complex abdominal aortic aneurysms. Journal of vascular surgery, 60(4), pp.858-864.

Reimerink, J.J., Hoornweg, L.L., Vahl, A.C., Wisselink, W., van den Broek, T.A., Legemate, D.A., Reekers, J.A. and Balm, R., 2013. Endovascular repair versus open repair of ruptured abdominal aortic aneurysms: a multicenter randomized controlled trial. Annals of surgery, 258(2), pp.248-256.

Reimerink, J.J., Hoornweg, L.L., Vahl, A.C., Wisselink, W., van den Broek, T.A., Legemate, D.A., Reekers, J.A. and Balm, R., 2013. Endovascular repair versus open repair of ruptured abdominal aortic aneurysms: a multicenter randomized controlled trial. Annals of surgery, 258(2), pp.248-256.