Résumé
With increasing age of the population and improvement of diagnostic tools, the incidence of abdominal aortic aneurysm [AAA] has been rising steadily. Thus, surgical repair of fissured or ruptured AAA needs a close analysis of the indications and therapeutic strategies. The aim of this study is to define the new criteria for surgical indications. Between 2000 and 2006, 26 consecutive patients with AAA underwent open operations for ruptured AAA in 22 [84%] and fissured AAA in 4 [16%]. The mean age was 59 years [26-S2years] and the predominant aetiology was the atherosclerosis [84%]. Radiological analysis showed a mean AAA diameter of 7,3cm [4-11cm]. The AAA repair was performed with tubular or bifurcated graft in 22 patients [84%], and the AAA exclusion associated to extra-anatomical revascularisation in 4 [16%]. Operative mortality was 23%and late follow up find no recidivant AAA. The high operative mortality rate of patients with complicated AAA is related to the unstable hemodynamic status and surgical difficulties. The finite radiological images description is the best way to find new predictive elements of rupture and indicate surgery even in small AAA