Endovascular vs. open surgery of abdominal aortic aneurysm in high-risk patients: a single center experience.
BACKGROUND
We compared two groups of high-risk patients with abdominal aortic aneurysm to assess the safety and efficacy of endovascular repair vs. open surgery.


METHODS
From January 1998 to July 2003, sixty-two high-risk patients were divided into two groups: group A consisted of 28 (46 %) open surgery patients and group B consisted of 34 (54 %) patients who underwent endovascular repair.


RESULTS
Four patients (14.3 %) in the open surgery group died, while no deaths occurred in the endovascular group ( p < 0.05). There were 14 complications in 8 patients of the open surgery group versus 2 complications in 2 patients of the endovascular group ( p = 0.01). At follow-up there were 4 (16.6 %) deaths in group A and 3 (8.8 %) in the endovascular group ( p = n. s.).


CONCLUSIONS
While the use of endovascular repair in patients who are physiologically fit for open surgical repair remains controversial, we believe that patients with multiple or advanced comorbidities, i.e. high-risk patients, can benefit from the endografting procedure.
Iannelli
G
G
Department of Cardiac Surgery, University of Naples Federico II, Naples, Italy. gabrieleiannelli@libero.it
Monaco
M
M
Di Tommaso
L
L
Piscione
F
F
Stassano
P
P
Mainenti
P P
PP
Laurino
S
S
Spampinato
N
N
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*