title: Large infra-renal abdominal aortic aneurysms: endovascular vs. open repair--single centre experience.
abstract: Endovascular aneurysm repair (EVAR) has become an established alternative to open repair (OR). We present a consecutive series of 486 elective patients with large infra-renal aortic abdominal aneurysm, comparing OR with EVAR. Prospective data collected during an 8-year period from January 1997 to October 2005 was reviewed. Statistical analysis performed using SPSS data editor with chi(2) tests and Mann-Whitney U-tests. There were 486 patients with 329 OR (293 males, 36 females) with median age of 72 years with median diameter 6.3 cm and 157 EVAR (148 males, 9 females) with median age 75 years with median diameter 6.1 cm. Mortality was 13 (4%) for OR and 5 (3.2%) for EVAR (three of whom were in the UK EVAR 2 trial). Blood loss was significantly less for EVAR 500 ml vs. 1500 ml for OR. Sixty-five (19.8%) patients with OR had significantly more peri-operative complications compared with 14 (8.9%) with EVAR. The length of stay in hospital was significantly less for EVAR. This non-randomised study shows that although EVAR does not have a statistically significantly lower mortality, it does have statistically significantly lower complication rates compared with OR. EVAR can be achieved with good primary success, but long-term follow-up is essential to assess durability.
authors.affiliation: Department of Vascular Surgery, Guy's & St Thomas' NHS Foundation Trust, Lambeth Palace Road, London, UK.
authors.forename: Y C
authors.initials: YC
authors.lastname: Chan
authors.forename: J P
authors.initials: JP
authors.lastname: Morales
authors.forename: N
authors.initials: N
authors.lastname: Gulamhuseinwala
authors.forename: T
authors.initials: T
authors.lastname: Sabharwal
authors.forename: M
authors.initials: M
authors.lastname: Carmichael
authors.forename: S
authors.initials: S
authors.lastname: Thomas
authors.forename: T W G
authors.initials: TW
authors.lastname: Carrell
authors.forename: J F
authors.initials: JF
authors.lastname: Reidy
authors.forename: P R
authors.initials: PR
authors.lastname: Taylor
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000401:mortality / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology*; D007902:Length of Stay; D008297:Male; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D012077:Renal Artery / Q000601:surgery*; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods* / Q000401:mortality