Experience in open surgical repair and endovascular repair for abdominal aortic aneurysm

Objective To evaluate the indications and the operation time on treatment of abdominal aortic aneurysm (AAA) with open surgical repair (OSR) and endovascular aortic repair (EVAR), and compare perioperative conditions between this two methods. Methods The clinical data of 33 cases of infrarenal AAA were analyzed from August 2005 to March 2010. The perioperative conditions were compared between elective OSR and elective EVAR. Results Of 5 cases who underwent emergency OSR, 1 died of multiple organ dysfunction on the day of surgery. Other 27 cases underwent elective operation. In OSR group: 1 case died of acute extensive anterior myocardial infarction on the second day after operation; 1 patient occurred right lower limb ischemia and color Doppler ultrasound revealed right external iliac artery stenosis, then the symptoms disappeared after drug treatment. In EVAR group, 2 patients had gluteal ache and difficulty in working in 1 month after procedure. All of patients were followed-up 1 to 3 months with good outcomes. EVAR was better than OSR in the items of operative time, blood loss, blood transfusion and hospital stay days except hospitalization expenses. Conclusions EVAR for AAA is minimally invasive and has a better short-term effect. And compared with OSR, EVAR is more suit to elderly patients and patients who cannot be able to bear or endure open operation, but the expenses is higher.