Mortality rates following endovascular repair of abdominal aortic aneurysms.
OBJECTIVE
To present the perioperative and late mortality following endovascular repair (EVR) of abdominal aortic aneurysms (AAAs).


METHODS
Data were collected prospectively on 221 patients undergoing AAA EVR over a 4-year period (median 5-month follow-up). Patients were classified preoperatively as high risk with at least 1 of these features: serum creatinine > 150 micromol/L, ischemic heart disease or poor left ventricular function, respiratory function < 50% of predicted normal, ruptured or symptomatic AAA, contraindication to or failed open repair, and age > 80 years.


RESULTS
One hundred forty (63.3%) patients were classified as high risk, the most common criterion being cardiac disease (n = 96, 68.6%). There were 25 (11.3%) deaths in the 30-day perioperative period, 22 (15.7%) in the high-risk group compared to 3 (3.7%) in the acceptable-risk group (p = 0.02). The most common causes of perioperative death were multisystem organ failure and myocardial infarction. A further 21 (9.5%) late deaths occurred, 16 (11.4%) in the high-risk group and 5 (6.2%) in the acceptable-risk group (p > 0.1).


CONCLUSIONS
The mortality of patients at acceptable risk undergoing EVR compares with the best published series for conventional open AAA repair. The perioperative and late mortality in the high-risk patients are substantially higher.
Walker
S R
SR
Department of Vascular and Endovascular Surgery, Queen's Medical Centre, Nottingham, United Kingdom. stuart.walker1@virgin.net
Macierewicz
J
J
MacSweeney
S T
ST
Gregson
R H
RH
Whitaker
S C
SC
Wenham
P W
PW
Hopkinson
B R
BR
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000401:mortality* / Q000601:surgery; D001019:Aortic Rupture / Q000401:mortality* / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation / Q000401:mortality*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality; D011184:Postoperative Period; D011446:Prospective Studies; D012307:Risk Factors; D015996:Survival Rate; D006113:United Kingdom / Q000453:epidemiology