title: Open surgery for abdominal aortic aneurysm in the era of endovascular repair: comparison with long term results of endovascular repair using zenith stentgraft.
abstract: OBJECTIVE
  Our study focuses on the long term result of open surgery and endovascular abdominal aortic aneurysm repair (EVAR) using the Zenith stentgraft.
  
  
  METHODS
  A total of 237 patients underwent elective abdominal aortic aneurysm (AAA) repair between April 1999 and December 2006. Nineteen patients underwent EVAR, whereas 218 patients underwent open surgery. The mean follow-up time for EVAR group was 73.8 ± 49 months (range; 25-150 months), and 69.7 ± 46 months (range; 1-156 months) for open surgery group.
  
  
  RESULTS
  One open surgery patient (1/218, 0.46%) died of aspiration pneumonia, whereas all the EVAR patients survived the operation. Remote complications requiring reintervention occurred in 8 patients (8/174, 4.6%) in open surgery group. Six EVAR patients (6/19, 31.6%) developed late aneurysm expansion, among whom four patients (4/19, 21.1%) required reinterventions after 3 or more years postoperatively. The need for reintervention persisted even at 11 years after initial EVAR. There was no significant intergroup difference in late mortality.
  
  
  CONCLUSIONS
  There was no statistically significant intergroup difference in early and long term mortality. Complications requiring reinterventions, however, were more frequent in EVAR than in open surgery, especially in the late period. Long term follow-up is mandatory for comparison of the clinical results between open surgery and EVAR.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan.
authors.forename: Hisato
authors.initials: H
authors.lastname: Ito
authors.forename: Takatsugu
authors.initials: T
authors.lastname: Shimono
authors.forename: Hideto
authors.initials: H
authors.lastname: Shimpo
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Kato
authors.forename: Kan
authors.initials: K
authors.lastname: Takeda
keywords: aneurysm; aorta; stentgraft; surgery