Abdominal Aortic Aneurysm

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Abstract
To test the hypothesis that endovascular repair of abdominal aortic aneurysm (AAA) will result in a significant reduction in mortality and morbidity rates and cost when compared with open transabdominal repair. Since the introduction of endovascular repair of AAA this decade, multiple groups have evaluated different endovascular grafts. Despite the excellent results reported initially, there has been a paucity of well-controlled, comparative studies looking at long-term outcome. From 1992 to 1998, the first 100 consecutive patients undergoing endovascular AAA repair (mean age 74.7, AAA size 5.6 cm) were compared to 100 patients undergoing transabdominal repair (mean age 72.9, AAA size 5.9 cm). All patients undergoing endovascular repair received a device manufactured by Endovascular Technologies, Inc. (Menlo Park, CA) and were prospectively followed with periodic examination, contrast-enhanced computed tomography, and duplex scanning. Of the 200 patients, 198 have been available for long-term follow-up. The two groups had similar preoperative risk factors. Surgical time (211 vs. 256 minutes, p Conclusions The surgical mortality rate is low for both groups and not statistically different. Endovascular repair significantly reduces resource utilization (surgical time, blood replacement, intensive care unit and hospital stay) and cost when compared to transabdominal aneurysm repair. Long-term survival is equivalent in patients undergoing AAA repair regardless of technique. Although endovascular repair appears durable for up to 6 years, longer follow-up studies are warranted.