Editor-in-Chief Ufuk Demirkılıç Frequency Quarterly Abbreviation Turk J Vasc Surg Publisher Turkish National Vascular and Endovascular Surgery Society E-ISSN 2667-5080

Turkish Journal of Vascular Surgery 2017 , Vol 26 , Issue 1
Comparison of short- and mid-term results of open surgery versus endovascular stent graft repair of abdominal aortic aneurysms
Mustafa Akbulut1, Eray Aksoy1, İbrahim Kara2, Ekin Can Çelik1, Murat Bülent Rabuş1, Davut Çekmecelioğlu1, Cengiz Köksal1
1Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Kalp ve Damar Cerrahisi Kliniği, İstanbul, Türkiye
2Sakarya Üniversitesi Tıp Fakültesi, Kalp ve Araştırma Hastanesi, Kalp ve Damar Cerrahisi Kliniği, Sakarya, Türkiye
DOI : 10.5606/tjvs.2017.6 Objectives: This study aims to compare short- and mid-term results of elective open surgery and endovascular aneurysm repair (EVAR) in the treatment of abdominal aortic aneurysms.

Patients and methods: A total of 113 patients (117 males, 16 females; mean age 67.1±9.0 years; range 40 to 86 years) who underwent elective EVAR or open surgery with the diagnosis of an infrarenal abdominal aortic aneurysm (aneurysm diameter >5.5 cm) between January 2009 and June 2014 were retrospectively analyzed. Preoperative risk factors of the patients, short-term mortality rates, need for blood transfusion, duration of mechanical ventilation support, postoperative complications, and the length of intensive care unit and hospital stays were recorded. All patients were postoperatively evaluated in the outpatient setting and computed tomography was performed. The mortality and need for re-intervention rates were compared.

Results: The mean follow-up was 29.6±20.0 months. Early mortality rate of the EVAR group was significantly lower (16.4% vs 2.6%; p<0.01). The need for blood transfusion, mechanical ventilation support, the length of intensive care unit and hospital stay were significantly lower in the EVAR group, compared to open surgery patients (p<0.01). Although the rate of postoperative complications was higher in the open surgery patients, there was no statistically significant difference compared to the EVAR group (p>0.05). During follow-up, there was no statistically significant difference in the need for re-intervention and late mortality rates and time of mortality between the groups (p>0.05).

Conclusion: Endovascular aneurysm repair is a preferable alternative in a selected high-risk patient population for open surgery owing to its remarkable advantages on short-term mortality and morbidity. However, there is no significant difference in the survival and need for re-intervention in the mid-term between the two techniques. Keywords : Abdominal aort aneurysm; endovascular repair; EVAR

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