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Giornale Italiano di Chirurgia Vascolare 2001 September;8(3):207-16

Copyright © 2002 EDIZIONI MINERVA MEDICA

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


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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.

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