Open Versus Endovascular Repair of Inflammatory Abdominal Aortic Aneurysms

Kakkos, Stavros K.; Papazoglou, Konstantinos; Tsolakis, Ioannis A.; Lampropoulos, George; Papadoulas, Spyros; Antoniadis, Pavlos

doi:10.1177/1538574415602780

Cited by 19 publications

(11 citation statements)

References 36 publications

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“…14 As EVAR is a less invasive technique than OSR, some authors have demonstrated that it is associated to fewer blood transfusions and shorter hospital stay. 6 However, we did not find any differences in our series.…”

Section: Discussioncontrasting

confidence: 70%

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Outcomes of open and endovascular repair of inflammatory abdominal aortic aneurysms

et al. 2017

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Objective Reports on inflammatory aortic abdominal aneurysm treatment are scarce. Traditionally, open surgery has been validated as the gold standard of treatment; however, high technical skills are required. Endovascular aortic repair has been suggested as a less invasive treatment by some authors offering good results. The purpose of our study was to report our experience and outcomes in the treatment of inflammatory aortic abdominal aneurysm using both approaches. Material and methods A retrospective review and data collection of all patients treated for inflammatory aortic abdominal aneurysm between 2000 and 2015 was done in one academic center. Diagnosis of inflammatory aortic abdominal aneurysm was based on preoperative CT-scan imaging. Type of treatment, postoperative and long-term morbidity and mortality are described. Abdominal compressive symptoms (hydronephrosis) severity and relief after treatment are described. Results Thirty-four patients with intact inflammatory aortic abdominal aneurysm were included. Twenty-nine (85.3%) patients were treated by open means and the remaining five (14.7%) with endovascular aortic repair. Nearly 90% were considered high-risk patients. Median follow-up was 46 months (range 24-112). The two groups were comparable, except for the age and preoperative hydronephrosis. There was no statistical significance in blood transfusion requirements, intensive care hospitalization, 30-day and long-term mortality between the two groups. Preoperative hydronephrosis was diagnosed in four (13.8%) patients in the open surgery group and three (60%) patients in the endovascular aortic repair group. Improvement of hydronephrosis was recognized in three out of the four patients in the open repair group and two out of the three in the endovascular aortic repair group. Renal function remained stable in both groups during follow-up. Conclusions Open surgery remains a safe and valid option for the treatment of inflammatory aortic abdominal aneurysm. Although our study included a small number of patients with endovascular aortic repair treatment, results are promising. Further randomized controlled studies may be necessary to assess long-term effectiveness of endovascular aortic repair treatment in this disease.

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Section: Discussioncontrasting

confidence: 70%

“…Some previous reports have suggested EVAR as a less invasive treatment for inflammatory aneurysms with less morbidity and mortality. 2,6 The aim of this study is to describe our postoperative and long-term institutional outcomes in the treatment of IAAA with both, open surgery and endovascular repair over a 15-year period.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of open and endovascular repair of inflammatory abdominal aortic aneurysms

et al. 2017

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“…14,17 These findings were in accordance with abdominal aortic aneurysms treated with OS or ET. 33,34…”

Section: Discussionmentioning

confidence: 99%

Endovascular Treatment Versus Open Surgery for Isolated Iliac Artery Aneurysms: A Systematic Review and Meta-Analysis

Xiang

Chen

Zhao

et al. 2019

Vasc Endovascular Surg

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Objective: The aim of this review was to compare the outcomes of endovascular treatment (ET) versus open surgery (OS) for patients with isolated iliac artery aneurysms (IIAAs). Methods: Studies that reported ET and OS for IIAAs were searched in databases until December 5, 2018. Studies were included for reporting both ET and OS for patients with IIAAs, and at least one of the following outcomes: postoperative mortality, postoperative ischemic complications (PIC), wound complications, blood transfusion, and length of hospital stay (LHS). We adopted Inverse Variance method to calculate the mean difference (MD) of LHS, and adopted Mantel–Haenszel method for odds ratios (ORs) of postoperative mortality, PICs, wound complications, and blood transfusion. Results: Nine studies were included, and all of them were observational studies, 7 studies were available for meta-analysis. When compared with OS, ET was associated with a higher risk of PICs (OR: 3.24, 95% confidence interval [CI]: 1.05-10.02), a lower risk of blood transfusion (OR: 0.22, 95% CI: 0.08-0.58), and a much shorter LHS (MD: −4.39, 95% CI: −6.18 to −2.60). The postoperative mortality and wound complication were similar between groups. Conclusion: Both ET and OS were safe and effective methods to repair IIAAs with similar postoperative mortality. Compared with OS, ET can reduce the need for transfusion and the time of LHS, but it was associated with a higher risk of PICs. The comparisons of primary patency and reintervention rates were still unclear between the 2 groups.

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“…Overall mortality was 14% (OR) vs. 2% (EVAR). Another analysis concerning inflammatory AAA concluded that EVAR is associated with shorter surgery duration, lower need for transfusion and lower morbidity compared to OR [112]. Nonetheless, there is no evidence-based proof that EVAR or OR should be preferred in inflammatory AAA.…”

Section: Inflammatory Aneurysmsmentioning

confidence: 99%

Short version of the S3 guideline on screening, diagnosis, therapy and follow-up of abdominal aortic aneurysms

Debus¹,

Heidemann²,

Gross-Fengels

et al. 2018

Gefässchirurgie

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Short version of the S3 guideline on screening, diagnosis, therapy and follow-up of abdominal aortic aneurysms On 3 July 2018, under the leadership of the German Society for Vascular Surgery and Vascular Medicine (DGG), the new S3 guidelines for screening, diagnosis, treatment, and follow-up for abdominal aortic aneurysms (AAA) were adopted by the DGG Executive Board, after unanimous approval by all participating profes

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Open Versus Endovascular Repair of Inflammatory Abdominal Aortic Aneurysms

Abstract: Endovascular aneurysm repair of IAAAs is associated with decreased procedure duration, transfusion needs, hospitalization, and morbidity compared to OSR.

Cited by 19 publications

References 36 publications

Outcomes of open and endovascular repair of inflammatory abdominal aortic aneurysms

Outcomes of open and endovascular repair of inflammatory abdominal aortic aneurysms

Endovascular Treatment Versus Open Surgery for Isolated Iliac Artery Aneurysms: A Systematic Review and Meta-Analysis

Short version of the S3 guideline on screening, diagnosis, therapy and follow-up of abdominal aortic aneurysms

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