VIENNA — Patients who underwent urgent or emergency repair of an abdominal aortic aneurysm had the worst survival rate among patients having open vascular surgery in a review of more than 2,700 patients at one center.
The greatest threat to survival for all patients having open vascular surgery were cerebrovascular and cardiovascular events, which were responsible for 76% of all deaths that occurred immediately following surgery, Dr. Gijs M.J.M. Welten and his associates said in a poster at the annual congress of the European Society of Cardiology. In addition, patients with cardiac complications during or immediately after vascular surgery have an increased risk of long-term death from all causes and chronic complications.
The study included 2,730 vascular surgery patients at Erasmus University in Rotterdam, the Netherlands, during a 13-year period. There were 1,047 patients having lower-limb reconstructive procedures, 923 undergoing elective infrarenal abdominal aortic aneurysm (AAA) repair, 560 having carotid endarterectomy (CEA), and 200 having urgent/emergency AAA repair. Overall perioperative mortality was 6%.
The perioperative mortality rate was by far the highest in the urgent or emergency AAA repair group, at 29%, Perioperative deaths occurred at a 6% rate in the elective AAA repair group, 3% in those having lower-limb reconstructions, and 1% in the CEA group, reported Dr. Welten, a researcher in the department of vascular surgery at Erasmus University.
Long-term survival was also the worst for patients with urgent or emergency AAA repair: Their 5-year survival rate was close to 40%, compared with about 60% in both the elective AAA repair and lower-limb surgery groups, and about 80% in the CAE group.