Has endovascular aneurysm repair improved outcome for patients with asymptomatic abdominal aortic aneurysm?

ABSTRACT

AIM: The aim of this study was to compare risk factors, complications, operative mortality and relative survival of patients treated with endovascular aneurysm repair (EVAR) for asymptomatic abdominal aortic aneurysm (AAA) to that of those subjected to open operation. SETTING: University Hospital. A total of 118 EVAR patients were compared with 386 with open repair during the period from 1995 through 2005, in a single center retrospective study. RESULTS: The two groups had similar risk profiles. EVAR patients were older and had shorter hospital stays than those with open operation. Throughout follow-up, 45.8% of EVAR patients had complications, as compared to only 26% of open repairs. Operative mortality, long-term survival and relative survival did not differ significantly between the two groups. CONCLUSION: EVAR appears initially safe in selected patients. The complication rate after EVAR is high, but declines throughout the study period. Focus must still be on patient selection and device improvement to reduce complications. The question whether EVAR has improved AAA treatment remains to be answered.