Cardiovascular Surgery and Interventions 2023, Vol 10, Num 3 Page(s): 170-176
Abdominal compartment syndrome following open and endovascular repair of ruptured abdominal aortic aneurysm

İlker Kızıloğlu1, Ahmet Daylan2

1Department of General Surgery, Izmir Bakırçay University Faculty of Medicine, Izmir, Türkiye
2Department of Cardiovascular Surgery, Izmir Bakırçay University Faculty of Medicine, Izmir, Türkiye

Keywords: Abdominal compartment syndrome, EVAR, intra-abdominal hypertension, ruptured abdominal aortic aneurysms
Objectives: This study aimed to reveal the incidence, treatment, and outcomes of abdominal compartment syndrome (ACS) following open or endovascular repair of ruptured abdominal aortic aneurysm (rAAA).

Patients and methods: The retrospective study included 36 patients (27 males, 9 females; mean age: 68.9±7.2 years; range, 61 to 81 years) who presented with rAAA between May 2016 and July 2023. In all patients, data regarding demographic characteristics, type of repair (open repair or endovascular aneurysm repair [EVAR]), ACS onset, morbidity, and mortality were recorded. The diagnosis of ACS was made by clinical signs and abdominal pressure measurements.

Results: The overall mortality was 41.7% (n=15). Abdominal compartment syndrome developed in five (13.9%) patients, including two (25%) of eight patients who underwent EVAR and three (10.7%) of 28 patients who underwent open repair. In the open repair group, three (60%) of five patients who developed ACS and 12 (38.7%) of 31 patients without ACS died while one (50%) of two patients who developed ACS died in the EVAR group. No death was noted among patients without ACS in the EVAR group.

Conclusion: This study shows that ACS can develop following both EVAR and open rAAA repair. Decompression laparotomy and open abdominal treatment should not be delayed when indicated. Although intra-abdominal pressure remains high, appropriate therapy may significantly affect outcomes.

DOI : 10.5606/e-cvsi.2023.1563