title: Results of Open and Endovascular Abdominal Aortic Aneurysm Repair According to the E-PASS Score.
abstract: BACKGROUND
  Endovascular repair (EVAR) of abdominal aortic aneurysm has become the standard of care due to a lower 30-day mortality, a lower morbidity, shorter hospital stay and a quicker recovery. The role of open repair (OR) and to whom this type of operation should be offered is subject to discussion.
  
  
  OBJECTIVE
  To present a single center experience on the repair of abdominal aortic aneurysm, comparing the results of open and endovascular repairs.
  
  
  METHODS
  Retrospective cross-sectional observational study including 286 patients submitted to OR and 91 patients submitted to EVAR. The mean follow-up for the OR group was 66 months and for the EVAR group was 39 months.
  
  
  RESULTS
  The overall mortality was 11.89% for OR and 7.69% for EVAR (P=0.263), EVAR presented a death relative risk of 0.647. It was also found a lower intraoperative bleeding for EVAR (OR=1417.48±1180.42 mL versus EVAR=597.80±488.81 mL, P<0.0002) and a shorter operative time for endovascular repair (OR=4.40±1.08 hours versus EVAR=3.58±1.26 hours,P<0.003). The postoperative complications presented no statistical difference between groups (OR=29.03% versus EVAR=25.27%, P=0.35).
  
  
  CONCLUSIONS
  EVAR presents a better short term outcome than OR in all classes of physiologic risk. In order to train future vascular surgeons on OR, only young and healthy patients, who carry a very low risk of adverse events, should be selected, aiming at the long term durability of the procedure.
authors.affiliation: Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.
authors.forename: Fábio Hüsemann
authors.initials: FH
authors.lastname: Menezes
authors.affiliation: Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.
authors.forename: Bárbara
authors.initials: B
authors.lastname: Ferrarezi
authors.affiliation: Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.
authors.forename: Moisés Amâncio de
authors.initials: MA
authors.lastname: Souza
authors.affiliation: Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.
authors.forename: Susyanne Lavor
authors.initials: SL
authors.lastname: Cosme
authors.affiliation: Hospital das Clinicas, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.
authors.forename: Giovani José Dal Poggetto
authors.initials: GJ
authors.lastname: Molinari
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000401:mortality* / Q000601:surgery*; D003430:Cross-Sectional Studies; D057510:Endovascular Procedures / Q000379:methods* / Q000401:mortality*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications; D012372:ROC Curve; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome