In patients stratified by preoperative risk, endovascular repair of ruptured abdominal aortic aneurysms has a lower in-hospital mortality and morbidity than open repair

Journal of Vascular Surgery
Mujtaba M AliWilliam P Robinson

Abstract

Previous studies have reported that endovascular repair (EVAR) of ruptured abdominal aortic aneurysms (RAAAs) has lower postoperative mortality than open repair (OR). However, comparisons involved heterogeneous populations that lacked adjustment for preoperative risk. We hypothesize that for RAAA patients stratified by a validated measure of preoperative mortality risk, EVAR has a lower in-hospital mortality and morbidity than does OR. In-hospital mortality and morbidity after EVAR and OR of RAAA were compared in patients from the Vascular Quality Initiative (2003-2013) stratified by the validated Vascular Study Group of New England RAAA risk score into low-risk (score 0-1), medium-risk (score 2-3), and high-risk (score 4-6) groups. Among 514 patients who underwent EVAR and 651 patients who underwent OR of RAAA, EVAR had lower in-hospital mortality (25% vs 33%, P = .001). In risk-stratified patients, EVAR trended toward a lower mortality in the low-risk group (n = 626; EVAR, 10% vs OR, 15%; P = .07), had a significantly lower mortality in the medium-risk group (n = 457; EVAR, 37% vs OR, 48%; P = .02), and no advantage in the high-risk group (n = 82; EVAR, 95% vs OR, 79%; P = .17). Across all risk groups, cardiac complications (...Continue Reading

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Citations

Feb 3, 2016·Journal of Vascular Surgery·Jeffrey J SiracuseUNKNOWN Vascular Quality Initiative
Apr 9, 2016·Langenbeck's Archives of Surgery·Andreas S PetersDittmar Böckler
Apr 8, 2017·Journal of Vascular Surgery·Paulo Thales Rocha de SousaPaulina Sannomiya
Sep 21, 2017·F1000Research·Norman R Hertzer
Apr 26, 2019·VASA. Zeitschrift für Gefässkrankheiten·Jonathan BathTodd R Vogel
Sep 3, 2020·Vascular and Endovascular Surgery·Jérémy MarchalMaxime Elens
Dec 24, 2020·Vascular and Endovascular Surgery·Drew J BraetTodd R Vogel
Jan 18, 2020·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·Mario D'OriaRandall R DeMartino
May 7, 2021·Journal of Vascular Surgery·Jake F HemingwayBenjamin W Starnes
Mar 18, 2019·Journal of Vascular Surgery·Kosmas I ParaskevasFrank J Veith

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