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

摘要

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.