Evolution in management and outcome after repair of abdominal aortic aneurysms in the pre- and post-EVAR era

Perspect Vasc Surg Endovasc Ther. 2013 Jun;25(1-2):11-9. doi: 10.1177/1531003513506267. Epub 2013 Nov 13.

Abstract

Objective: To compare outcomes of abdominal aortic aneurysm repairs before and after the endovascular era.

Methods: Group A (1997-1998) included 331 patients, 321 (97%) with open repair (OR) and 10 (3%) with endovascular aneurysm repair (EVAR). Group B (2007-2008) included 330 patients, 136 (41%) with OR and 194 (59%) with EVAR.

Results: Patients in Group B were older (74 ± 8.5 vs 73 ± 7.0 years, P = .02), had higher comorbidity scores (8.3 ± 4.8 vs 7.5 ± 4.6, P = .04), shorter hospitalization (5.1 ± 6.4 vs 9.8 ± 6.3, P < .001), less intensive care unit days than in Group B (0.9 ± 2.1 vs 2.2 ± 2.7, P < .001). Early mortality was 0.6% in both groups. Two-year survival was similar (88% vs 89%), with less reinterventions in Group A (4% vs 17%, P = .004). OR patients had similar 30-day mortalities (0.9% vs 0.7%, P = .89).

Conclusion: EVAR and OR have low mortalities. However, in the post-EVAR era we treat older patients with more comorbidities, hospitalization is shorter, and intensive care unit days are less; interventions in EVAR are, however, high.

Keywords: abdominal aortic aneurysm; endovascular repair; open repair.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aortic Aneurysm, Abdominal / diagnosis
  • Aortic Aneurysm, Abdominal / mortality
  • Aortic Aneurysm, Abdominal / surgery*
  • Blood Vessel Prosthesis Implantation* / adverse effects
  • Blood Vessel Prosthesis Implantation* / mortality
  • Blood Vessel Prosthesis Implantation* / trends
  • Comorbidity
  • Endovascular Procedures* / adverse effects
  • Endovascular Procedures* / mortality
  • Endovascular Procedures* / trends
  • Female
  • Humans
  • Intensive Care Units
  • Kaplan-Meier Estimate
  • Length of Stay
  • Male
  • Registries
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Treatment Outcome