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The Evaluation of Endovascular Aneurysm Repair for Medium-risk and High-risk Surgical Patients

Author: ChangHaiYang
Tutor: WuXiaoPeng
School: Shandong University
Course: General Surgery
Keywords: Abdominal aortic aneurysms the evaluated risk prediction score system endovascular aneurysm repair open surgical repair evaluatio
CLC: R654.3
Type: Master's thesis
Year: 2011
Downloads: 33
Quote: 0
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Abstract


Background:Abdominal aortic aneurysms (AAAs) occur in about 5% of men aged over 50 years. The incidence appears to be increasing, partly as a result of the increasing age of the population and also because of greater diagnostic awareness. There are two kinds of clinical treatments for abdominal aortic aneurysm:open surgical repair(OSR) and endovascular aneurysm repair(EVAR).For patient with co morbidities, to have an operation is more dangerous. How to handle this puzzle is becoming more and more important for vascular surgeons.Object:To evaluate the therapeutic effects of endovascular aneurysm repair for medium-risk and high-risk surgical patients.Methods:The clinical data of 47 patients with abdominal aortic aneurysm treated were analyzed controlled by the invaluable risk prediction score system. According to this system, patients were classified as low risk、medium risk and high risk. We compared the differences between medium risk patients and high risk patients in per operative and short term advantages and disadvantages.Results:By the comparison, patients who underwent EVAR had significant reductions in blood loss、operative time、ICU time、postoperative hospital stay、postoperative mortality. However, they spent more money. We calculated that high-risk patients should receive EVAR before committing to OSR. Conclusions:1、endovascular aneurysm repair is more beneficial for AAA patients, but it costs more money compared to open surgical repair.2、Since the approval of endoluminal grafts for treatment of AAA, EVAR has expanded to include patients originally considered too ill for OSR. However, some concern has been expressed regarding technical failure and the durability of endovascular grafts.3、For high-risk patients, it is more suitable to receive endovascular aneurysm repair.4、Scoring method for prediction of mortality of patients undergoing AAA repair is beneficial for surgeon to make clinic decision, no matter EVAR or OSR.

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CLC: > Medicine, health > Surgery > Of surgery > Cardiovascular and lymphatic system surgery > Vascular
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