An Analysis Of Diagnosis And Therapy For107Cases With Abdominal Aortic Aneurysm

Purpose: Investigation the diagnosis and therapy method of abdominal aorticaneurysm (AAA), analyze the advantage and disadvantage of the endovascular repairfor AAA (EVAR).Method: Retrospective study107patients who suffered AAA from Jan.2008toMarch2012in Wuhan Union Hospital.Result:(1) Epidemiology: There are107patients suffered AAA,87of them are male, theother20patients are female (4.35:1), Age of the patients was from30to87,average age is68.7.(2) Clinical performance: The most common complaint of these patients wasaugmented abdominal pulsatile mass (74.77%),30patients with abdominaldistention,20patients with abdominal pain,8patients with intermittentclaudication;7patients suffered the ruptured AAA,6of them got uncontrolledhemorrhagic shock and inevitably dead.20asymptomatic patients werediagnosised by the Doppler ultrasound or CT when they received the medicalexamination.(3) History:94patients had hypertention (87.85%),44patients had chronicpulmonary disease (41.12%),15patients had coronary heart disease (14.01%),9patients had diabetes mellitus (8.41%),3patients had renal disfunction (2.8%).(4) Imageology examination: all the patients received the Doppler ultrasound or CTprior to admission.100patients received CTA,68patients received DSA during the EVAR.1patients The other7patients were not received CTA or DSA,6withhemorrhagic shock,1with Iodine allergy test positive.(5) Surgical therapy:68patients received the endovascular repair for AAA,20ofthem had endoleak during the operation (29.4%),8case received the ballooncatheter dilatation and successfully extinguished endoleak;5patients received theAbdominal aortic aneurysm resection and Artificial vascular replacement(OR);34patients rejected the surgical therapy.(6) Prognosis: Compare the EVAR and OR, we found that EVAR had the advantagein average stay (17.6vs28.4days), postoperative stay (9.47vs17.6days), theamount of blood transfusion (80.6vs1600ml) and hospital expenses (155vs61thousand RMB).7patients who suffered the ruptured AAA received theanti-shock therapy and only1patient survived, the mortality is85.7%.Conclusion: AAA is one of the most serious disease in the surgery, hypertention andagedness are high risk factors, the male had4times higher morbidity than female.Early in the disease, AAA is asymptomatic, which are primarily diagnosised by theDoppler ultrasound or CT during the medical examination; when the disease developsinto the mid and late stage, it probably arises abdominal pain and abdominal pulsatilemass and it is easily misdiagnosis. The definite diagnosis for AAA depends onangiography, such as CTA or DSA. Because of the mobility is positively related withthe diameter and morphology of AAA, the study suggest that the actively surgicaltherapy can effectively prevent the AAA rupture and avoid the rupture-related death.Compared the EVAR and OR, EVAR has the advantage in decreasing the operativerisk factor, average stay and postoperative stay, but with relatively higher hospitalexpenses and the graft-related complication need to be followed up.