RECENT reports suggest an improved survival rate following resection of the "emergency" abdominal aneurysm.1,2 An analysis of our experience allows us to postulate reasons for this change in concept.
An abdominal aneurysm becomes an emergency when surgical interference is necessary to save life or limb.
There were 102 emergency resections and graft replacements of the abdominal aorta carried out on our service at the University of Western Ontario in the last ten years. In the majority of cases, a bifurcation graft was used with end-to-end anastomosis to the common iliac artery. An end-to-side anastomosis to more distal vessels was performed if there was associated proximal disease. The aneurysm was confined to the aorta in four patients; and in one patient, the limb of the graft was carried to the popliteal artery.A separate anastomosis or graft to a renal artery in two, to an inferior messentaric artery