Comparison of Endovascular Aneurysm Repair with Open Repair in Patients with Abdominal Aortic Aneurysm in Our Own Material in Years 2002-2011

Abstract

Background. Endovascular abdominal aortic aneurysm repair has become an alternative to open surgical repair of abdominal aortic aneurysm since the early 1990s. The conventional method remains the gold standard in the treatment of Abdominal Aortic Aneurysm (AAA); however, a large percentage of patients do not qualify for this treatment due to the high risk of perioperational death and complications. Objectives. The objective of this work was to compare AAA surgeries performed by both classical and endovascular methods in years 2002-2011. Material and Methods. Medical documentation of elective AAA patients undergoing surgical treatment was retrospectively analyzed on the basis of archive-and computer database data. The analysis included the patients' demographics, internal disease burden, as well as causes of deaths and complications within 30 days after the procedure and 1 year follow-up. Results. Thirty-day and 1-year mortality rates in patients treated in the elective setting were 1.5% and 8.7% for endovascular method and 4.0% and 15.7% for the open method. The comparison of mortality rates in 115 high-risk patients undergoing elective OR treatment with 275 high-risk treatment patients undergoing EVAR surgery (7.8% vs. 1.5%, 8.7% vs. 15.7%, p < .01) showed that the endovascular method significantly reduced the mortality in the latter group. Conclusions. Endovascular treatment is an attractive option in AAA; especially in heavily burdened patients, because it definitely reduces mortality. EVAR was found to be advantageous over OR in case of high-risk patients (Adv Clin Exp Med 2015, 24, 3, 475-479).

Clinical evaluation of endovascular repair of abdominal aortic aneurysm based on long-term experiences.

“…World studies on AAA patients treated during elective admissions using the endovascular method show short-term mortality rates of 0 to 4.3% [1,5,7,13,15,[18][19][20][21][22][23][24][25][26][27][28][29][30]. The short-term mortality of 2.5% characterized the patients with elective endovascular treatment in the present study and is comparable to cited reports.…”

“…The present study analyses the treatment outcomes for 236 AAA patients subject to planned endovascular surgery between 2010 and 2015. The patients with AAA treated in the elective endovascular method demonstrated a low short-term mortality rate, which is no different from worldwide reports on the use of the endovascular technique [1,5,7,13,15,[18][19][20][21][22][23][24][25][26][27][28][29][30]. Furthermore, in this study the observed and predicted short-term mortality rates according to the V-Possum scale were not significantly different (p = 0.7993).…”

Short-term outcomes of endovascular repair of abdominal aortic aneurysm, including ruptured cases.

“…Due to the low invasiveness, less trauma and perioperative pain, as well as shorter hospitalization time and faster return to full fitness, the endovascular technique is becoming the preferred treatment for AAA patients worldwide [ 1 – 7 ]. In a UK study, AAA patients undergoing planned endovascular treatment were found to have low rates of short-term mortality and complications – 0% and 12%, respectively.…”

“…The relatively low invasiveness of the endovascular method allows the procedure to be performed under local anesthesia, with less trauma and less perioperative pain. The potential benefits of the endovascular method also include shorter hospitalization and a reduction in the rates of perioperative complications and mortality [ 3 – 7 ].…”

Endovascular Management of Abdominal Aortic Aneurysms: the Year in Review

“…In high-risk patients (n = 275) with infra-renal AAA, EVAR has been shown in a retrospective study to have significantly lower mortality at 30 days and 1 year compared with open repair [32]. Utilization of EVAR for ruptured AAA is also expanding.…”