Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 2.1
5-Year Impact Factor – 2.2
Scopus CiteScore – 3.4 (CiteScore Tracker 3.4)
Index Copernicus  – 161.11; MEiN – 140 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

Download original text (EN)

Advances in Clinical and Experimental Medicine

2015, vol. 24, nr 3, May-June, p. 475–479

doi: 10.17219/acem/29184

Publication type: original article

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Comparison of Endovascular Aneurysm Repair with Open Repair in Patients with Abdominal Aortic Aneurysm in Our Own Material in Years 2002–2011

Jan Gnus1,A,C,D,E,F, Stanisław Ferenc1,A,C,D,E,F, Małgorzata Dziewiszek2,D, Lesław Rusiecki3,B, Wojciech Witkiewicz1,A,F

1 Department of General and Vascular Surgery, Research and Development Centre, Voivodship Specialist Hospital in Wroclaw, Poland

2 Faculty of Medicine, Wroclaw Medical University, Poland

3 Laboratory of Biostatistics and Medical Informatics, Wroclaw Medical University, Poland

Abstract

Background. Endovascular abdominal aortic aneurysm repair has become an alternative to open surgical repair of abdominal aortic aneurysm since the early 1990s. The conventional method remains the gold standard in the treatment of Abdominal Aortic Aneurysm (AAA); however, a large percentage of patients do not qualify for this treatment due to the high risk of perioperational death and complications.
Objectives. The objective of this work was to compare AAA surgeries performed by both classical and endovascular methods in years 2002–2011.
Material and Methods. Medical documentation of elective AAA patients undergoing surgical treatment was retrospectively analyzed on the basis of archiveand computer database data. The analysis included the patients’ demographics, internal disease burden, as well as causes of deaths and complications within 30 days after the procedure and 1 year follow-up.
Results. Thirty-day and 1-year mortality rates in patients treated in the elective setting were 1.5% and 8.7% for endovascular method and 4.0% and 15.7% for the open method. The comparison of mortality rates in 115 high-risk patients undergoing elective OR treatment with 275 high-risk treatment patients undergoing EVAR surgery (7.8% vs. 1.5%, 8.7% vs. 15.7%, p < .01) showed that the endovascular method significantly reduced the mortality in the latter group.
Conclusion. Endovascular treatment is an attractive option in AAA; especially in heavily burdened patients, because it definitely reduces mortality. EVAR was found to be advantageous over OR in case of high-risk patients.

Key words

abdominal aortic aneurysm, endovascular aneurysm repair, open repair.

References (23)

  1. Johnston KW, Rutherford RB, Tilson MD: Suggested standards for reporting on arterial aneurysms. Subcommittee on Reporting Standards for Arterial Aneurysms, Ad Hoc Committee on Reporting Standards, Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery. J Vasc Surg 1991, 13, 452–458.
  2. Zankl AR, Schumacher H, Krumsdorf U: Pathology, natural history and treatment of abdominal aortic aneurysms. Clin Res Cardiol 2007, 96, 140–151.
  3. Sakalihasan N, Limet R, Defawe OD: Abdominal aortic aneurysm. Lancet 2005, 365, 1577–1589.
  4. Singh K, Bonaa KH, Jacobsen BK: Prevalence and risk factors for abdominal aortic aneurysms in a populationbased study: the Tromso study. Am J Epidemiol 2001, 154, 236–244.
  5. Greenhalgh RM, Brown LC, Kwong GP: 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.
  6. Greenhalgh RM: Endovascular aneurysm repair and outcome in patients unfit for open repair of abdominal aortic aneurysm (EVAR trial 2): randomised controlled trial. Lancet 2005, 365, 2187–2192.
  7. Saratzis N, Melas N, Saratzis A: Anaconda™ Aortic Stent-Graft: Single-Center Experience of a New Commercially Available Device for Abdominal Aortic Aneurysm. J Endovasc Ther 2008, 15, 33–41.
  8. Lindholt JS, Norman P: Screening for abdominal aortic aneurysm reduces overall mortality in men. A metaanalysis of the mid-and long-term effects of screening for abdominal abdominal aneurysms. Eur J Vasc Endovasc Surg 2008, 36, 167–171.
  9. Jean-Baptiste E, Hassen-Khodja R, Bouillanne PJ: Endovascular Repair of Infrarenal Abdominal Aortic Aneurysms in High-Risk-Surgical Patients. Eur J Vasc Endovasc Surg 2007, 34, 145–151.
  10. Geraghty PJ, Sicard GA: Abdominal aortic aneurysm repair in high risk and elderly patients. J Cardiovasc Surg 2003, 44, 543–547.
  11. Mastracci TM, Greenberg RK, Hernandez AV: Defining high risk in endovascular aneurysym repair. J Vasc Surg 2010, 51, 1088–1095.
  12. Schouten O, Dunkelgrun M, Feringa HH: Myocardial Damage in High-risk Patients Undergoing Elective Endovascular or Open Infrarenal Abdominal Aortic Aneurysm. Eur J Vasc Endovasc Surg 2007, 33, 544–549.
  13. Forbes TL, Steiner SH, Lawlor DK: Risk-Adjusted Analysis of Outcomes Following Elective Open Abdominal Aortic Aneurysm Repair. Ann Vasc Surg 2005, 15, 142–148.
  14. Jordan WD, Alcocer F, Wirthlin DJ: Abdominal Aortic Aneurysm in “High-Risk” Surgical Patients. Ann Vasc Surg 2003, 5, 623–630.
  15. Zannetti S, De Rango P, Parlani G: Endovascular Abdominal; Aortic Aneurysm Repair in High-risk Patients: a Single Centre Experience. Eur J Vasc Endovasc Surg 2001, 21, 334–338.
  16. Steinmetz E, Abello N, Kretz B: Analysis of Outcome after using High-risk Criteria Selection to Surgery Versus Endovascular Repair in the Modern Era of Abdominal Aortic Aneurysm Treatment. Eur J Vasc Endovasc Surg 2010, 39, 403–409.
  17. Rango PD, Verzini F: Commentary to “Endovascular Repair of Infrarenal Abdominal Aortic Aneurysm in High Surgical Risk Patients”. Eur J Vasc Endovasc Surg 2007, 34, 152–153.
  18. Sayers RD, Thompson MM, Nasim A: Surgical Management of 671 Abdominal Aortic Aneurysms: A 13 Year Review from a Single Centre. Eur J Vasc Endovasc Surg 1997, 13, 322–327.
  19. Chew HF, You CK, Brown MG: Mortality, Morbidity, and Cost of Ruptured and Elective Abdominal Aortic Aneurysm Repairs in Nova Scotia, Canada. Ann Vasc Surg 2003, 17, 171–179.
  20. Franks SC, Sutton AJ, Bown MJ: Systematic review and meta-analysis of 12 years of endovascular abdominal aortic aneurysym repair. Eur J Vasc Endovasc Surg 2007, 33, 154–171.
  21. Alric P, Ryckwaert F, Picot MC: Ruptured Aneurysm of the Infrarenal Abdominal Aorta: Impact of Age and Postoperative Complications on Mortality. Ann Vasc Surg 2003, 17, 277–283.
  22. Biancari F, Catania A, D’Andrea V: Elective Endovascular vs. Open Repair for Abdominal Aortic Aneurysm in Patients Aged 80 Years and Older: Systematic Review and Meta-Analysis. Eur J Vasc Endovasc Surg 2011, 42, 571–576.
  23. Wahlgren CM, Malmstedt J: Outcomes of endovascular abdominal aortic aneurysm repair compared with open surgical repair in high-risk patients: Results from the Swedish Vascular Registry. Swedish Vascular Registry 2008, 1382–1389.