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Jornal Vascular Brasileiro

Print version ISSN 1677-5449On-line version ISSN 1677-7301

Abstract

MIRANDA, Samuel de Paula et al. Open vs. endovascular repair of abdominal aortic aneurysm: a comparative analysis. J. vasc. bras. [online]. 2014, vol.13, n.4, pp.276-284. ISSN 1677-5449.  http://dx.doi.org/10.1590/1677-5449.0118.

Context:

Abdominal aortic aneurysm (AAA) is a condition that is usually asymptomatic, but potentially fatal, and has a prevalence in men over 60 years old ranging from 4.3% to 8%. There are two treatment options available: open surgery (OS) and endovascular treatment (ET).

Objective:

To compare the results of repairs conducted using these two treatment methods from 2008 to 2013 in a tertiary hospital.

Methods:

A retrospective analysis comparing 119 patients treated with OS and 219 patients who underwent ET for AAA repair.

Results:

The ET group was older (71.3 vs. 68.2 years; p<0.001) and had a higher rate of coronary disease (44.7% vs. 27.7%; p=0.002) and a lower ejection fraction (57.6% vs. 64.3%; p<0.001); in turn, the OS group had more chronic obstructive pulmonary disease (16.0% vs. 5.9%; p=0.004) and a smaller proximal infrarenal neck (15.5 mm vs. 23.0 mm; p<0.001). However, there was no difference in ASA classification (American Society of Anesthesiology) (p=0.36). The ET group had less intraoperative bleeding (171 mL vs. 729 mL; p<0.001) and required fewer blood transfusions (11.9% vs. 73.1% p<0.001), and spent shorter stays in both ICU (2.4 vs. 3.5 days; p=0.002) and hospital (5.8 vs. 10.3 days; p<0.001). Thirty-day mortality was similar (OS 5.0% vs. ET 4.1%; p=0.78) and there was also no difference in postoperative complications. The average cost of ET was higher (R$34,277.76 vs. R$4,778.60; p<0.001).

Conclusions:

Rates of morbidity and mortality were similar, although ET was associated with less bleeding, fewer transfusions and shorter hospital stays, but was more expensive.

Keywords : abdominal aortic aneurysm; vascular surgical procedures; endovascular procedures.

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