[Abdominal aortic aneurysms--long-term treatment results].
OBJECTIVE
To evaluate the single center experience in the treatment of patients with AAA.


METHODS
586 patients undergoing open resection (OR) and EVAR (2000-2009). The average age was 72.2 +/- 7.7 years. AAA diameter was 8.3 cm (range 5.0-13.1 cm). 451 (76.9%) patients had asymptomatic AAA, 135 (23.1%) RAAA. 448 patients (76.5%) suffered from various co-morbidities. 430 (73.4 %) OR, 156 (26.6%) EVAR and 52 (8.9%) one staged procedure (for concomitant diseases) was performed.


RESULTS
30 days mortality rate of elective OR and EVAR was 6.2, resp. 2.9% (n.s.) versus 36.6% of RAAA (p < 0.0001). 30 days mortality rate of one staged and single procedure was 19.5, resp. 3.6% (p < 0.0001). 30 days morbidity rate was in the whole group 52.1% (80.7% in RAAA x 43.4% in asymptomatic AAA - p < 0.0001), in one-stage procedures 60.8% x 51.1% in single procedures - n.s., 45.1% in OR x 39.0% in EVAR - n.s. Redo procedures were significantly higher in EVAR x OR in the long-term period after primary procedure. 1-, 3-, 5-, and 8 years survival of patients with asymptomatic AAA and RAAA was 91.6, 85.9, 81.1 and 73.6%, resp. 54.9, 48.9, 45.9 and 43.5 years (p < 0.0001). 1-, 3-, and 5 years patients survival with single versus one staged procedures was 85.5, 80.5 and 71.0% versus 71.1, 68.0 and 74.6% (n.s.). 1-, 3-, and 5- years patients survival after OR or EVAR was 91.2, 87.1 and 80.6%, resp. 90.7, 79.9 and 74.6 % (n.s.). The significant influence on patients long-term survival had RAAA, age of patients, postoperative complications and one stage procedures.


CONCLUSIONS
High percentage of polymorbidity was the cause of the significant 30 days postoperative mortality of patients after OR. EVAR and OR have similar long-term results. One staged procedures should be used very carefully in selected patients due to the higher mortality rate and worse long-term patients survival.
Treska
V
V
Chirurgická klinika FN a LF UK v Plzni. treska@fnplzen.cz
Certík
B
B
Kuntscher
V
V
Sulc
R
R
Molácek
J
J
Houdek
K
K
Slauf
F
F
Novák
M
M
Tresková
I
I
Narsanská
A
A
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D012307:Risk Factors; D015996:Survival Rate