Endovascular repair of ruptured abdominal aortic aneurysm does not confer survival benefits over open repair

Journal of Vascular Surgery
Naveed SaqibJae-Sung Cho

Abstract

Endovascular repair of ruptured abdominal aortic aneurysm (rAAA) is being increasingly performed despite lack of good evidence for its superiority. Other reported studies suffer from patient selection and publication bias with limited follow-up. This study is a single-center propensity score comparing early and midterm outcomes between open surgical repair (OSR) and endovascular repair of rAAA (REVAR). A retrospective review from January 2001 to November 2010 identified 312 patients who underwent rAAA repairs. Thirty-one patients with antecedent AAA repair and three with incomplete records were excluded, leaving 37 REVARs and 241 OSRs. Propensity score-based matching for sex, age, preoperative hemodynamic status, surgeon's annual AAA volume, and preoperative cardiopulmonary resuscitation was performed in a 1:3 ratio to compare outcomes. Thirty-seven REVARs were matched with 111 OSRs. Late survival was estimated by Kaplan-Meier methods. Operative time and blood replacement were higher with OSR. Overall complication rates were similar (54% REVAR vs 66% OSR; P = .23), except for higher incidences of tracheostomies (21% vs 3%; P = .015), myocardial infarction (38% vs 18%; P = .036), and acute tubular necrosis (47% vs 21%; P = .009)...Continue Reading

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Citations

Feb 11, 2015·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·L Dubois
Feb 25, 2014·Journal of Vascular Surgery·Anahita DuaSapan S Desai
May 31, 2013·Journal of Vascular Surgery·Paola De RangoUNKNOWN rEVAR in Women Collaborators Group
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