Introduction: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).Conclusion: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.
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