Significance of delayed surgical treatment of symptomatic non-ruptured abdominal aortic aneurysm

Abstract

Introduction. An abdominal aortic aneurysm is a permanent focal dilation of the blood vessel wall to about 1.5 times larger than the normal diameter. Clinically, it may be divided into symptomatic and asymptomatic. It is still discussed whether patients with symptomatic non-ruptured abdominal aortic aneurysm benefit more from emergency or delayed surgical treatment. The aim of the study was to evaluate the results of the symptomatic non-ruptured aneurysms in regard to the diameter of ruptured and non-ruptured symptomatic aneurysms and the impact of the time elapsed from admission to surgery on its outcome. Material and Methods. The retrospective study included all 133 patients who underwent surgery due to symptomatic non-ruptured or ruptured abdominal aortic aneurysm at the Clinic of Vascular and Endovascular Surgery during the previous 3 years. Results. Out of a total of 133 patients, 75.19% underwent surgery in the first 24 hours after admission, while the rest 24.81% of patients were operated later. Intraoperative complications were recorded only in patients with ruptured aneurysms, 4% had cardiac arrest and 1.5% of patients had fatal outcome. The in-hospital mortality was 16.67% in patients with non-ruptured aneurysm of the abdominal aorta operated in the first 24 hours, and 9.91% in patients who were operated after 24 hours after admission. Conclusion. Early elective surgery is a method of choice in the treatment of symptomatic non-ruptured aneurysm of the abdominal aorta. However, surgical treatment in the first 24 hours is associated with a higher mortality rate than surgery after 24 hours after admission. Also, there is no statistically significant difference in the diameter of ruptured and non-ruptured symptomatic aneurysms, but the average size of the aneurysm diameter is higher in ruptured than in non-ruptured aneurysms, which confirms the fact that the increase in diameter increases the risk of aneurysm rupture.