[Open and endovascular surgery for the treatment of abdominal aortic aneurysm. Review of the available evidence].
Open and endovascular surgery are therapeutic alternatives for the treatment of abdominal aortic aneurysm. The development of guidelines for its treatment requires a thorough analysis of available evidence to recommend the best treatment for each country's reality. Prospective randomized trials have shown best initial results with endovascular surgery, with higher hospital costs than open surgery. The requirement of anatomical suitability for the placement of endovascular prostheses limits the universal use of endovascular surgery. Moreover, this type of surgery needs a strict imaging and clinical follow up due to the high rates of late complications, which range from 20% to 40%. Many of these complications require further surgical interventions, elevating costs of treatment. The initial benefit of endovascular surgery is lost during long follow up as survival curves become similar to those of open surgery. Even for patients with a high surgical risk, the benefits of endovascular surgery are doubtful.
Mariné M
Leopoldo
L
Departamento de Cirugía Vascular y Endovascular, División de Cirugía, Pontificia Universidad Católica de Chile, Santiago, Chile. marinepolo@yahoo.com
Valdés E
Francisco
F
Mertens M
Renato
R
Krämer Sch
Albrecht
A
Bergoeing R
Michel
M
Rivera D
Dixiana
D
Vergara G
Jeanette
J
Carvajal N
Claudia
C
D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D019317:Evidence-Based Medicine; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D014656:Vascular Surgical Procedures / Q000009:adverse effects* / Q000191:economics / Q000379:methods