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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
A Journal on Vascular and Endovascular Surgery
Giornale Italiano di Chirurgia Vascolare 2001 September;8(3):207-16
language: English, Italian
Chronic contained rupture in aortic aneurysms. Clinical presentation and results
Faggioli G. L., Pilato A., Curti T., Ferri M., Palumbo N.
From the Vascular Surgery University of Bologna, Bologna, Italy
Background. The chronic contained rupture of an aneurysm (CCRA) is a rare occurrence. The cases reported in the literature are therefore sporadic. In this paper we report the clinical characteristics and immediate results of the cases we have observed.
Methods. A retrospective analysis was made of all cases of CCRA treated surgically from 1992 to today, evaluating symptoms, morphological characteristics of the aneurysm, site of rupture, type of surgery, perioperative mortality and morbidity. The results were compared with those of uncomplicated abdominal aortic aneurysms (AAA) treated during the same period.
Results. Twenty-four CCRA were treated. The symptoms (backache, aspecific abdominal pain, hypotensive episodes) were present in 14 cases (58.3%). The maximum mean transverse diameter was 6.49±1.7 cm. Anemia was present in 6/14 symptomatic patients (43%); asymptomatic patients never presented anemia (0%, p<0.05). There was no correlation between the site of rupture (anterolateral in nine cases – 37.5% and posterior in 15 cases – 62.5%) and symptoms. There was no statistically significant difference in mortality and morbidity in CCRA vs those in the 996 cases of AAA treated during the same period (9.1 vs 7.2%, p=NS), but there was a trend towards higher mortality (4.5 vs 0.8%, p=0.07).
Conclusions. CCRA have specific symptoms in 60% of cases. The operating results did not differ from those in AAA, although the trend towards mortality was higher. These results justify the indications for surgical treatment of these forms, also in view of their unforeseeable evolution.