Mid-term survival and costs of treatment of patients with descending thoracic aortic aneurysms; endovascular vs. open repair: a case-control study.
OBJECTIVE
To evaluate the results of open surgery or endovascular stent graft repair of descending thoracic aortic aneurysm (TAA).


METHODS
This is a retrospective multicenter study of 95 patients undergoing TAA repair (42 stent grafts, 53 open repair). The median age was 67 years. Post-operative complications, mid-term survival and costs were assessed. The results were pooled with data in the literature.


RESULTS
After a mean follow up of 26 months (open group) and 15 months (endovascular group) survival was similar for patients treated by either repair method. Post-operative pneumonia was more in the open group (p <0.02). The hospital costs of open treatment were 40% more than that of the endovascular procedure. Combining the present results with pooled data from the literature the peri-operative mortality and paraplegia rate was less in the endovascular group (p <0.05).


CONCLUSIONS
These retrospective data suggest that endografting of descending thoracic aneurysms can be performed with less peri-operative morbidity, at lower hospital costs, but with equal mid-term life expectancy, compared with open grafting.
Glade
G J
GJ
Department of Surgery, Onze Lieve Vrouwe Gasthuis, 1090 HM Amsterdam, The Netherlands.
Vahl
A C
AC
Wisselink
W
W
Linsen
M A M
MA
Balm
R
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000191:economics* / Q000401:mortality; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000191:economics* / Q000401:mortality; D016022:Case-Control Studies; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D015607:Stents; D016019:Survival Analysis