Comparision Of Traditional Open Repair And Endovascular Aortic Repair In The Treatment Of Abdominal Aortic Aneurysm

Objective:To summarize and analyze the short-term clinical effects of endovascular aortic repair(EVAR)and traditional open repair(OR)in the treatment of infrarenal abdominal aortic aneurysm.To get the advantages and disadvantages of the two surgical options.This study will provide an important reference for the treatment strategy of the abdominal aortic aneurysm.Methods:Clinical data of 92 patients were collected who were diagnosed as infrarenal abdominal aortic aneurysm at the Second Hospital of Jilin University from January 1,2011 to December 31,2019.According to the surgical method,they were divided into EVAR group and OR group.There were 64 patients in EVAR group and 28 patients in OR group.These patients’general clinical data,intraoperative data and postoperative clinical data were recorded and compared.Results:There were 64 patients in the EVAR group,including 50 men and 14 women;there were 28 patients in the OR group,including 21 men and 7 women.In the EVAR and OR groups,the age of the patients is(68.23±9.4 years old vs 65.3±9.0 years old,P>0.05);the maximum diameter of the abdominal aortic aneurysm is(54.1±14.5mm vs 59.2±15.3 mm,P>0.05);and the ejection fraction is(62.7%±6.3%vs60.1%±8.2%,P>0.05);body surface area is(1.75±0.20 m~2 vs 1.75±0.21 m~2,P>0.05);preoperative rupture rate is(9.38%vs 21.43%,P>0.05).There was no significant difference in general clinical data and preoperative complications between the two groups(P>0.05).There was no intraoperative death among 92 patients,and the operation success rate was 100%.During the postoperative hospitalization,there was 1 death in the EVAR group and 1 death in the OR group.There was no significant difference in mortality between the two groups(1.56%vs 3.57%,P>0.05).Regarding the operation time;intraoperative blood transfusion rate;postoperative using time of ventilator;postoperative fasting time;postoperative ICU stay time and postoperative hospital stay time;the EVAR group was significantly less than the OR group(P<0.001).The incidence of short-term complications after surgery was lower in the EVAR group than in the OR group,such as cardiac insufficiency(0 vs.7.14%),acute kidney injury(4.67%vs.25%)and infection(0 vs.17.86%)(P<0.05).There was no statistically significant difference in the incidence of complications such as liver dysfunction,cerebral infraction,respiratory insufficiency,occlusion of main branch artery,abdominal distension,endoleak and iliac artery embolism(P<0.05).Two patients in the EVAR group were lost to follow-up 1 year after operation while one patient in the OR group was lost to follow-up.Among the follow-up patients,1patient died of unknown cause in the EVAR group 2 months after operation;1 patient died of unknown cause in the OR group 17 months after operation.During the follow-up period,there was no statistically significant difference in mortality between the two groups(1.64%vs 3.85,P>0.05).The remaining patients in both groups completed the aortic CTA reexamination 1 year after operation.It can be seen that the blood circulation of the vascular prosthesis is good,and the morphology and structure are normal.There is no endoleak.Conclusions:EVAR and OR in the treatment of infrarenal abdominal aortic aneurysms have good surgical results and satisfactory results.Both are safe and effective surgical techniques.However,compared to OR,EVAR can significantly simplify surgical operations,reduce the intraoperative injuries,reduce the incidence of short-term perioperative complications,reduce postoperative intensive care unit stay time and hospital stay time.