title: Open and endovascular elective treatment of abdominal aortic aneurysms: a real-world experience.
abstract: OBJECTIVE
  To present a real-world experience of the elective treatment of abdominal aortic aneurysms (AAAs) using both open repair (OR) and endovascular repair (EVAR).
  
  
  METHODS
  Data from patients treated consecutively between January 1, 2000 and December 31, 2014 were collected retrospectively and reviewed. The primary outcomes were 30-day mortality and complication rates, freedom from reintervention, and survival in the long-term.
  
  
  RESULTS
  We analyzed data on 1112 patients (660 EVAR, 452 OR). The 30-day mortality and complications rates were higher after OR than after EVAR (2.9 vs. 1.1%, P = .03 and 24.7 vs. 1.1%, P < .0001, respectively). At 10 years, survival was 66.1 ± 3.2% after OR and 78.1 ± 2.2% after EVAR (P = .0006) and freedom from reintervention was 93.5 ± 1.8% after OR and 88.4 ± 1.8% after EVAR (P = .005). The preoperative aneurysm diameter was significantly associated with the development of type Ia endoleaks after EVAR (P < .0001) and of a proximal pseudoaneurysm after OR (P < .0001).
  
  
  CONCLUSIONS
  In the long-term, EVAR was associated with higher reintervention rates, but better survival than OR. The preoperative AAA diameter was the most important predictor of the development of endoleaks after EVAR and proximal pseudoaneurysm after OR.
authors.affiliation: First Unit of Vascular Surgery, IRCCS Policlinico San Donato, Piazza Malan,1, 20097, San Donato Milanese, MI, Italy. danymazzak83@libero.it.
authors.forename: Daniela
authors.initials: D
authors.lastname: Mazzaccaro
authors.affiliation: First Unit of Vascular Surgery, IRCCS Policlinico San Donato, Piazza Malan,1, 20097, San Donato Milanese, MI, Italy.|University of Milan, Milan, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Nano
authors.affiliation: Unit of Vascular Surgery, Azienda Ospedaliera Ospedale San Carlo Borromeo Milano, Milan, Italy.
authors.forename: Alberto M
authors.initials: AM
authors.lastname: Settembrini
authors.affiliation: Unit of Vascular Surgery, Azienda Ospedaliera Ospedale San Carlo Borromeo Milano, Milan, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Carmo
authors.affiliation: Unit of Vascular Surgery, Azienda Ospedaliera Ospedale San Carlo Borromeo Milano, Milan, Italy.
authors.forename: Raffaello
authors.initials: R
authors.lastname: Dallatana
authors.affiliation: Unit of Vascular Surgery, Azienda Ospedaliera Ospedale San Carlo Borromeo Milano, Milan, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Salvati
authors.affiliation: First Unit of Vascular Surgery, IRCCS Policlinico San Donato, Piazza Malan,1, 20097, San Donato Milanese, MI, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Malacrida
authors.affiliation: University of Milan, Milan, Italy.|Unit of Vascular Surgery, Azienda Ospedaliera Ospedale San Carlo Borromeo Milano, Milan, Italy.
authors.forename: Piergiorgio G
authors.initials: PG
authors.lastname: Settembrini
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D017558:Elective Surgical Procedures; D057510:Endovascular Procedures / Q000379:methods* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*
keywords: Abdominal aortic aneurysm; Endovascular repair; Long-term results; Open repair; Real-world experience