title: Abdominal aortic aneurysm repair in obese patients: improved outcome after endovascular treatment compared with open surgery.
abstract: OBJECTIVE
  To investigate outcomes in obese patients with abdominal aortic aneurysm (AAA) treated with elective open or endovascular repair (EVAR).
  
  
  METHODS
  We compared the outcomes of obese patients with AAA treated with elective open repair and EVAR. Obesity was defined as a body mass index (BMI) > or =30 kg/m( 2).
  
  
  RESULTS
  A total of 56 patients with a BMI > or =30 kg/m(2) were identified for analysis (mean age 70 +/- 8 years; mean BMI 34 +/- 4 kg/m(2), and 95% [n = 53] were male). Open surgery was performed in 55% (n = 31). The in-hospital complication rate (including nonsurvivors) was significantly increased after open repair compared with EVAR (26% vs 4%, P = .033). Mortality did not differ significantly during 3 years of follow-up (P = .816). Length of stay, intensive care unit (ICU) stay, and need for ventilation were significantly increased after open surgery compared with EVAR.
  
  
  CONCLUSIONS
  We observed improved short-term outcomes among obese AAA patients after EVAR compared to open repair. Endovascular repair may be preferable in obese patients with AAA.
authors.affiliation: Department of Surgery and Radiology, Sections of Vascular Surgery and Interventional Radiology, Yale University School of Medicine, New Haven, Connecticut, VA Connecticut Healthcare System, West Haven, CT, USA.
authors.forename: Frederik H W
authors.initials: FH
authors.lastname: Jonker
authors.forename: Felix J V
authors.initials: FJ
authors.lastname: Schlösser
authors.forename: Michael
authors.initials: M
authors.lastname: Dewan
authors.forename: Matthew
authors.initials: M
authors.lastname: Huddle
authors.forename: Michael
authors.initials: M
authors.lastname: Sergi
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: Indes
authors.forename: Alan
authors.initials: A
authors.lastname: Dardik
authors.forename: Bart E
authors.initials: BE
authors.lastname: Muhs
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000401:mortality / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality; D015992:Body Mass Index; D003422:Critical Care; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000401:mortality; D012121:Respiration, Artificial; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome