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Review
, 22, 34-44

Endovascular vs. Open Repair for Ruptured Abdominal Aortic Aneurysm

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Review

Endovascular vs. Open Repair for Ruptured Abdominal Aortic Aneurysm

Nikolaos Patelis et al. Med Sci Monit Basic Res.

Abstract

Background: Patients presenting with ruptured abdominal aortic aneurysms are most often treated with open repair despite the fact that endovascular aneurysm repair is a less invasive and widely accepted method with clear benefits for elective aortic aneurysm patients. A debate exists regarding the definitive benefit in endovascular repair for patients with a ruptured abdominal aortic aneurysm. The aim of this literature review was to determine if any trends exist in favor of either open or endovascular repair.

Material and methods: A literature search was performed using PUBMED, OVID, and Google Scholar databases. The search yielded 64 publications.

Results: Out of 64 publications, 25 were retrospective studies, 12 were population-based, 21 were prospective, 5 were the results of RCTs, and 1 was a case-series. Sixty-one studies reported on early mortality and provided data comparing endovascular repair (rEVAR) and open repair (rOR) for ruptured abdominal aneurysm groups. Twenty-nine of these studies reported that rEVAR has a lower early mortality rate. Late mortality after rEVAR compared to that of rOR was reported in 21 studies for a period of 3 to 60 months. Results of 61.9% of the studies found no difference in late mortality rates between these 2 groups. Thirty-nine publications reported on the incidence of complications. Approximately half of these publications support that the rEVAR group has a lower complication rate and the other half found no difference between the groups. Length of hospital stay has been reported to be shorter for rEVAR in most studies. Blood loss and need for transfusion of either red cells or fresh frozen plasma was consistently lower in the rEVAR group.

Conclusions: Differences between the included publications affect the outcomes. Randomized control trials have not been able to provide clear conclusions. rEVAR can now be considered a safe method of treating rAAA, and is at least equal to the well-established rOR method.

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Cited by 4 PubMed Central articles

References

    1. Karthikesalingam A, Holt PJ, Vidal-Diez A, et al. Mortality from ruptured abdominal aortic aneurysms: clinical lessons from a comparison of outcomes in England and the USA. Lancet. 2014;383(9921):963–69. - PubMed
    1. Marin ML, Veith FJ, Cynamon J, et al. Initial experience with transluminally placed endovascular grafts for the treatment of complex vascular lesions. Ann Surg. 1995;222(4):449–65. discussion 465–69. - PMC - PubMed
    1. Yusuf SW, Whitaker SC, Chuter TA, et al. Emergency endovascular repair of leaking aortic aneurysm. Lancet. 1994;344(8937):1645. - PubMed
    1. McHugh SM, Aherne T, Goetz T, et al. Endovascular versus open repair of ruptured abdominal aortic aneurysm. Surgeon. 2015 [Epub ahead of print] - PubMed
    1. Mayer D, Rancic Z, Veith FJ, Lachat M. Part two: Against the motion. EVAR offers no survival benefit over open repair for the treatment of ruptured abdominal aortic aneurysms. Eur J Vasc Endovasc Surg. 2015;49(2):119–27. - PubMed

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