Indicators of survival after open repair of ruptured abdominal aortic aneurysms and an index for predicting aneurysmal rupture potential.

BACKGROUND The aims of this study were to assess variables associated with survival in patients undergoing ruptured abdominal aortic aneurysm (RAAA) repair and to develop an index other than the aneurysmal diameter to predict rupture potential. METHODS This study included 43 consecutive patients who underwent open surgery for RAAAs. RESULTS The mortality rate was 18.6% (8/43). The ratio between the maximum aneurysmal diameter and the length (along the central axis) from the aneurysmal neck to the point at which the diameter was three-fourth of the maximum aneurysmal diameter was used as an index to predict aneurysmal rupture potential. The index score was 2.7 ± 1.2 in the RAAA and 1.9 ± 0.9 in the EAAA (p = 0.018). For aneurysms of ≤ 6-cm diameter, the index score was 3.0 ± 1.0 in the RAAA and 1.8 ± 0.9 in the EAAA (p = 0.03). All patients in the EAAA except one had an index score of < 2.3 and 6 of the 7 patients with RAAA had a score of > 3. CONCLUSIONS The results suggest that patients with AAA having scores of > 3 are at high risk of rupture. This index would be useful for decision making regarding repair of AAA, especially in the borderline cases.