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Open and endovascular elective treatment of abdominal aortic aneurysms: a real-world experience

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Abstract

Purpose

To present a real-world experience of the elective treatment of abdominal aortic aneurysms (AAAs) using both open repair (OR) and endovascular repair (EVAR).

Methods

Data from patients treated consecutively between January 1, 2000 and December 31, 2014 were collected retrospectively and reviewed. The primary outcomes were 30-day mortality and complication rates, freedom from reintervention, and survival in the long-term.

Results

We analyzed data on 1112 patients (660 EVAR, 452 OR). The 30-day mortality and complications rates were higher after OR than after EVAR (2.9 vs. 1.1%, P = .03 and 24.7 vs. 1.1%, P < .0001, respectively). At 10 years, survival was 66.1 ± 3.2% after OR and 78.1 ± 2.2% after EVAR (P = .0006) and freedom from reintervention was 93.5 ± 1.8% after OR and 88.4 ± 1.8% after EVAR (P = .005). The preoperative aneurysm diameter was significantly associated with the development of type Ia endoleaks after EVAR (P < .0001) and of a proximal pseudoaneurysm after OR (P < .0001).

Conclusion

In the long-term, EVAR was associated with higher reintervention rates, but better survival than OR. The preoperative AAA diameter was the most important predictor of the development of endoleaks after EVAR and proximal pseudoaneurysm after OR.

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Authors and Affiliations

  1. First Unit of Vascular Surgery, IRCCS Policlinico San Donato, Piazza Malan,1, 20097, San Donato Milanese, MI, Italy

    Daniela Mazzaccaro, Giovanni Nano & Giovanni Malacrida

  2. University of Milan, Milan, Italy

    Giovanni Nano & Piergiorgio G. Settembrini

  3. Unit of Vascular Surgery, Azienda Ospedaliera Ospedale San Carlo Borromeo Milano, Milan, Italy

    Alberto M. Settembrini, Michele Carmo, Raffaello Dallatana, Simone Salvati & Piergiorgio G. Settembrini

Authors
  1. Daniela Mazzaccaro
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  2. Giovanni Nano
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  3. Alberto M. Settembrini
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  4. Michele Carmo
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  5. Raffaello Dallatana
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  6. Simone Salvati
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  7. Giovanni Malacrida
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  8. Piergiorgio G. Settembrini
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Corresponding author

Correspondence to Daniela Mazzaccaro.

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Conflict of interest

Daniela Mazzaccaro and her co-authors have no conflicts of interest.

Additional information

D. Mazzaccaro and G. Nano shared first authorship.

P. G. Settembrini: SVS Member.

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Mazzaccaro, D., Nano, G., Settembrini, A.M. et al. Open and endovascular elective treatment of abdominal aortic aneurysms: a real-world experience. Surg Today 47, 1347–1355 (2017). https://doi.org/10.1007/s00595-017-1525-7

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  • DOI: https://doi.org/10.1007/s00595-017-1525-7

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