Large infra-renal abdominal aortic aneurysms: endovascular vs. open repair - single centre experience

Abstract

Summary Endovascular aneurysm repair (EVAR) has become an established alternative to open repair (OR). We present a consecutive series of 486 elective patients with large infra‐renal aortic abdominal aneurysm, comparing OR with EVAR. Prospective data collected during an 8‐year period from January 1997 to October 2005 was reviewed. Statistical analysis performed using SPSS data editor with χ2 tests and Mann–Whitney U‐tests. There were 486 patients with 329 OR (293 males, 36 females) with median age of 72 years with median diameter 6.3 cm and 157 EVAR (148 males, 9 females) with median age 75 years with median diameter 6.1 cm. Mortality was 13 (4%) for OR and 5 (3.2%) for EVAR (three of whom were in the UK EVAR 2 trial). Blood loss was significantly less for EVAR 500 ml vs. 1500 ml for OR. Sixty‐five (19.8%) patients with OR had significantly more peri‐operative complications compared with 14 (8.9%) with EVAR. The length of stay in hospital was significantly less for EVAR. This non‐randomised study shows that although EVAR does not have a statistically significantly lower mortality, it does have statistically significantly lower complication rates compared with OR. EVAR can be achieved with good primary success, but long‐term follow‐up is essential to assess durability.

Systematic review and meta-analysis of the early and late outcomes of open and endovascular repair of abdominal aortic aneurysm

“…A total of 29 papers were read in full. Eighteen studies were excluded for the following reasons: two were meta‐analyses, two were RCTs with fewer than 200 patients, six non‐randomized studies had fewer than 2000 patients, one study investigated challenging aortic necks, one investigated aortoiliac aneurysms, two investigated high‐risk patients, one was a prospective non‐randomized trial with fewer than 2000 patients, one was a systematic review, one included only patients aged more than 80 years, and one excluded patients aged over 60 years ( Fig . ).…”

Comparative evaluation of ballet-type and conventional stent graft configurations for endovascular aneurysm repair: A CFD analysis

“…The direction of the displacement forces was noted to be in upward direction. Though the migration of the SGs in the upward direction is a rare phenomenon, however, multiple reports support this observation [ 68–70 ]. However, it is worth mentioning that these displacements forces tend to be lower in magnitude than the displacement resistance offered by active fixations e.g.…”

A Computational Study of the Magnitude and Direction of Migration Forces in Patient-specific Abdominal Aortic Aneurysm Stent-Grafts

“…20 Upward device migration, though very rare, has been shown to occur in AAA stent-grafts. 21,22 Different aortic waveforms were investigated in patient 1. Alteration of the aortic pulse duration had a negligible effect on the drag force.…”