Acute endovascular treatment to improve outcome of ruptured aortoiliac aneurysms.

Participants:

- 3 Hospitals: Academic Medical Center, VU Medical Center and Onze Lieve Vrouwe Gasthuis

- Randomized multicenter trial in the Amsterdam region.

Acute endovascular treatment improves outcome of ruptured aortoiliac aneurysms.

N/A

1. CT angiography: all patients with suspected rupture of an abdominal aortic aneurysm will be examined by CT angiography to confirm the diagnosis of a ruptured aneurysm and to evaluate the anatomical suitability for endovascular treatment. The patient is entered in the study if the aneurysm is ruptured, the anatomical criteria for endovascular repair are fulfilled and the patient is fit for an open procedure.
Patients will then be randomized for either open or endovascular treatment. If possible informed consent is obtained, if the clinical condition of the patient does not allow for a proper informed consent, informed consent will be asked after the patient has been treated (in accordance with Dutch Law: WMO §2, artikel 6-1);

2. Open procedure: patient under general anesthesia, laparotomy, standard aortic repair with either an aortic tube graft or a bifurcated graft, standard closure.

3. Endovascular procedure: Local anesthesia of both groin regions, dissection of the common femoral arteries, placement of aorto-uni-iliac endovascular graft through one of the femoral arteries and placement of an iliac occluder in the contra lateral iliac artery, placement of a femoro-femoral cross-over bypass.