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.
ParodiJCPalmazJCBaroneHD. Transfemoral intraluminal graft implantation for abdominal aortic aneurysms. Ann Vasc Surg. 1991;5:491-499.
2.
GreenhalghRMBrownLCPowellJTThompsonSGEpsteinDSculpherMJ. Endovascular versus open repair of abdominal aortic aneurysm. N Engl J Med. 2010;362:1863-1871.
3.
De BruinJLBaasAFButhJ. Long-term outcome of open or endovascular repair of abdominal aortic aneurysm. N Engl J Med. 2010;362:1881-1889.
4.
LederleFAFreischlagJAKyriakidesTC. Long-term comparison of endovascular and open repair of abdominal aortic aneurysm. N Engl J Med. 2012;367:1988-1997.
5.
StatherPWSidloffDDattaniNChokeEBownMJSayersRD. Systematic review and meta-analysis of the early and late outcomes of open and endovascular repair of abdominal aortic aneurysm. Br J Surg. 2013;100:863-872.
6.
LederleFAFreischlagJAKyriakidesTC. Outcomes following endovascular vs open repair of abdominal aortic aneurysm: a randomized trial. JAMA. 2009;302:1535-1542.
7.
ElkouriSGloviczkiPMcKusickMA. Endovascular repair of abdominal aortic aneurysms: initial experience with 100 consecutive patients. Mayo Clin Proc. 2003;78:1234-1242.
8.
ElkouriSGloviczkiPMcKusickMA. Perioperative complications and early outcome after endovascular and open surgical repair of abdominal aortic aneurysms. J Vasc Surg. 2004;39:497-505.
9.
GilesKAPomposelliFHamdanAWyersMJhaveriASchermerhornML. Decrease in total aneurysm-related deaths in the era of endovascular aneurysm repair. J Vasc Surg. 2009;49:543-550.
10.
BlankensteijnJDde JongSEPrinssenM. Two-year outcomes after conventional or endovascular repair of abdominal aortic aneurysms. N Engl J Med. 2005;352:2398-2405.
11.
CostinJAWatsonDRDuffSBEdmonson-HoltAShafferLBlossomGB. Evaluation of the complexity of open abdominal aneurysm repair in the era of endovascular stent grafting. J Vasc Surg. 2006;43:915-920.
12.
Ballotta E, Da GiauGGruppoMMazzalaiFSpirchSTerranovaO. Elective abdominal aortic aneurysm repair in the very elderly: a systematic review. Minerva Med. 2009;100:95-103.
13.
ChaikofELFillingerMFMatsumuraJS. Identifying and grading factors that modify the outcome of endovascular aortic aneurysm repair. J Vasc Surg. 2002;35:1061-1066.
14.
ThomasSMGainesPABeardJD. Short-term (30-day) outcome of endovascular treatment of abdominal aortic aneurism: results from the prospective Registry of Endovascular Treatment of Abdominal Aortic Aneurism (RETA). Eur J Vasc Endovasc Surg. 2001;21:57-64.
15.
AdriaensenMEBoschJLHalpernEFMyriam HuninkMGGazelleGS. Elective endovascular versus open surgical repair of abdominal aortic aneurysms: systematic review of short-term results. Radiology. 2002;224:739-747.
16.
PrinssenMVerhoevenELButhJ. A randomized trial comparing conventional and endovascular repair of abdominal aortic aneurysms. N Engl J Med. 2004;351:1607-1618.
17.
GreenhalghRMBrownLCKwongGPPowellJTThompsonSG. Comparison of endovascular aneurysm repair with open repair in patients with abdominal aortic aneurysm (EVAR trial 1), 30-day operative mortality results: randomised controlled trial. Lancet. 2004;364:843-848.
18.
de la MotteLJensenLPVogtKKehletHSchroederTVLonnL. Outcomes after elective aortic aneurysm repair: a nationwide Danish cohort study 2007-2010. Eur J Vasc Endovasc Surg. 2013;46:57-64.
19.
CaseyKHernandez-BoussardTMellMWLeeJT. Differences in readmissions after open repair versus endovascular aneurysm repair. J Vasc Surg. 2013;57:89-95.
20.
Endovascular aneurysm repair versus open repair in patients with abdominal aortic aneurysm (EVAR trial 1): randomised controlled trial. Lancet. 2005;365:2179-2186.
21.
AlbuquerqueFCJrTonnessenBHNollREJrCiresGKimJKSternberghWC3rd. Paradigm shifts in the treatment of abdominal aortic aneurysm: trends in 721 patients between 1996 and 2008. J Vasc Surg. 2010;51:1348-1352.
22.
HiromatsuSSakashitaHOkazakiTOnitsukaSTanakaAFukunagaS. Perioperative outcomes for elective open abdominal aortic aneurysm repair since the adoption of endovascular grafting procedures. Eur J Vasc Endovasc Surg. 2011;42:178-184.
23.
ChadiSARoweBWVogtKN. Trends in management of abdominal aortic aneurysms. J Vasc Surg. 2012;55:924-928.
24.
BakoyiannisCNTsekourasNSGeorgopoulosSE. Minilaparotomy abdominal aortic aneurysm repair in the era of minimally invasive vascular surgery: preliminary results. ANZ J Surg. 2009;79:829-835.
