title: Endovascular abdominal aortic aneurysm repair at hartford hospital: a six year experience.
abstract: OBJECTIVE
  Endograft repair of abdominal aortic aneurysms (AAA) has become a viable alternative to open surgical repair in the last decade. We report here our experience and analysis of the surgical outcomes associated with endograft AAA repair.
  
  
  METHODS
  Patients suffering from significant abdominal aortic aneurysms (> 5cm in diameter) underwent endovascular repair. We report our experience with 342 consecutive patients from June 1998 to December 2004. Outcomes such as perioperative mortality, length of admission, length of ICU admission, operative blood loss, rates of transfusion postoperatively, rates of postoperative myocardial infarction (MI), rates of lower extremity ischemia, rates of conversion to open surgery, and the incidence of postoperative endoleaks were reviewed and analyzed. These results were compared to our patients undergoing open AAA repair during the same time period. Differences in the rates of perioperative mortality (2.0% vs 5.3%, NS) were not significant. However, the length of admission (4.8 vs 11.6 days, P=<0.001), length of ICU admission (0.6 vs 3.8 days, P=<0.001), blood transfusion (0.27 vs 1.83 units, P=<0.001), rates of postoperative MI (0.9% vs 5.0%, P=<0.001), and the incidence of postoperative renal insufficiency (4.1% vs 22.2%, P=<0.001) were superior in our endovascular group as compared to our open subset. In addition, most of our results were comparable to those results reported in recent major trials of endograft AAA repair.
  
  
  CONCLUSIONS
  Endograft repair of AAA demonstrated superior outcomes when compared to our patients undergoing open AAA repair. However, these results must be weighed against the risk of endoleaks, secondary interventions, and routine radiographic surveillance required for the endovascular approach.
authors.affiliation: Hartford Hospital, CT 06102-5037, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Park
authors.forename: Stratton
authors.initials: S
authors.lastname: Danes
authors.forename: A David
authors.initials: AD
authors.lastname: Drezner
authors.forename: James
authors.initials: J
authors.lastname: Gallagher
authors.forename: Phillip
authors.initials: P
authors.lastname: Allmendinger
authors.forename: Robert
authors.initials: R
authors.lastname: Lowe
authors.forename: Mary
authors.initials: M
authors.lastname: Windels
authors.forename: John
authors.initials: J
authors.lastname: Foster
authors.forename: Michael
authors.initials: M
authors.lastname: Hallisey
authors.forename: Diane
authors.initials: D
authors.lastname: Miller
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D003237:Connecticut; D005260:Female; D006786:Hospitals, Urban; D006801:Humans; D008297:Male; D011446:Prospective Studies; D016896:Treatment Outcome