Evolution in management and outcome after repair of abdominal aortic aneurysms in the pre- and post-EVAR era

Michele Piazza, Peter Gloviczki, Ying Huang, Manju Kalra, Audra A. Duncan, Gustavo Oderich, William S. Harmsen, Thomas C. Bower

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objective. To compare outcomes of abdominal aortic aneurysm repairs before and after the endovascular era. Methods. Group A (1997-1998) included 331 patients, 321 (97%) with open repair (OR) and 10 (3%) with endovascular aneurysm repair (EVAR). Group B (2007-2008) included 330 patients, 136 (41%) with OR and 194 (59%) with EVAR. Results. Patients in Group B were older (74 ± 8.5 vs 73 ± 7.0 years, P =.02), had higher comorbidity scores (8.3 ± 4.8 vs 7.5 ± 4.6, P =.04), shorter hospitalization (5.1 ± 6.4 vs 9.8 ± 6.3, P <.001), less intensive care unit days than in Group B (0.9 ± 2.1 vs 2.2 ± 2.7, P <.001). Early mortality was 0.6% in both groups. Two-year survival was similar (88% vs 89%), with less reinterventions in Group A (4% vs 17%, P =.004). OR patients had similar 30-day mortalities (0.9% vs 0.7%, P =.89). Conclusion. EVAR and OR have low mortalities. However, in the post-EVAR era we treat older patients with more comorbidities, hospitalization is shorter, and intensive care unit days are less; interventions in EVAR are, however, high.

Original languageEnglish (US)
Pages (from-to)11-19
Number of pages9
JournalPerspectives in Vascular Surgery and Endovascular Therapy
Volume25
Issue number1-2
DOIs
StatePublished - Jun 1 2013

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Abdominal Aortic Aneurysm
Aneurysm
Intensive Care Units
Mortality
Comorbidity
Hospitalization
Survival

Keywords

  • abdominal aortic aneurysm
  • endovascular repair
  • open repair

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

Cite this

Evolution in management and outcome after repair of abdominal aortic aneurysms in the pre- and post-EVAR era. / Piazza, Michele; Gloviczki, Peter; Huang, Ying; Kalra, Manju; Duncan, Audra A.; Oderich, Gustavo; Harmsen, William S.; Bower, Thomas C.

In: Perspectives in Vascular Surgery and Endovascular Therapy, Vol. 25, No. 1-2, 01.06.2013, p. 11-19.

Research output: Contribution to journalArticle

Piazza, Michele ; Gloviczki, Peter ; Huang, Ying ; Kalra, Manju ; Duncan, Audra A. ; Oderich, Gustavo ; Harmsen, William S. ; Bower, Thomas C. / Evolution in management and outcome after repair of abdominal aortic aneurysms in the pre- and post-EVAR era. In: Perspectives in Vascular Surgery and Endovascular Therapy. 2013 ; Vol. 25, No. 1-2. pp. 11-19.
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N2 - Objective. To compare outcomes of abdominal aortic aneurysm repairs before and after the endovascular era. Methods. Group A (1997-1998) included 331 patients, 321 (97%) with open repair (OR) and 10 (3%) with endovascular aneurysm repair (EVAR). Group B (2007-2008) included 330 patients, 136 (41%) with OR and 194 (59%) with EVAR. Results. Patients in Group B were older (74 ± 8.5 vs 73 ± 7.0 years, P =.02), had higher comorbidity scores (8.3 ± 4.8 vs 7.5 ± 4.6, P =.04), shorter hospitalization (5.1 ± 6.4 vs 9.8 ± 6.3, P <.001), less intensive care unit days than in Group B (0.9 ± 2.1 vs 2.2 ± 2.7, P <.001). Early mortality was 0.6% in both groups. Two-year survival was similar (88% vs 89%), with less reinterventions in Group A (4% vs 17%, P =.004). OR patients had similar 30-day mortalities (0.9% vs 0.7%, P =.89). Conclusion. EVAR and OR have low mortalities. However, in the post-EVAR era we treat older patients with more comorbidities, hospitalization is shorter, and intensive care unit days are less; interventions in EVAR are, however, high.

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