Retrospectively Clinical Controlled Study On Endovascular Abdomonal Aortic Aneurysm Repair Versus Conventional Open Surgical Repair Of Abdominal Aortic Aneurysm

Objective:Analysis parts of Abdominal aortic aneurysm patients admitted in our department between January 2003 to January 2010 retrospectively. Study the clinical traits and treatment method.Further more,compare the effect and their own characteristics of endovascular abdominal aortic aneurysm surgery (EVAR)and traditianal open surgical repair (OSR).Materials and Methods:There are 120 patients about abdominal aortic aneurysms(AAA) between January 1,2003 to January 31,2010;among them,115 cases were infraenal abdominal aortic aneurysm,5 cases were thorcoabdominal aortic aneurysm. Ruptured abdominal aortic aneurysm(RAAA) were found in 16 cases(1 case was thorcoabdominal aortic aneurysm), mycotic abdominal aortic aneurysms(MAAA),inflammatory abdominal aortic aneurysms(IAAA) and tuberculosis abdominal aortic aneurysms were found in 3,4 and 3 cases respectively. Comparison of patients treated with endovascular repair (EVAR group, n=36) and traditional open surgery patients (OSR group, n=84) in the preoperative condition, operative time, blood loss and blood transfusion, ICU hospital stay, postoperative hospital stay, total hospitalization time,postoperative complications, perioperative survival rates and the accumulative survival rate.Results:Number of cases was 120.92 cases were male (76.67%), 28 cases were female (23.33%); EVAR group aged 40-89 years,mean age was (71.25±9.98); OSR group aged 31-83 years, mean age was(64.18±14.25),the difference was significant (p<0.05).Combine with coronary heart disease and malignant tumor were 18(50.0%) and 4(11.1%)in EVAR group compared with 22(26.19%)and 0(0%)in OSR group(P<0.05).The mean operation time, blood loss, blood transfusion, ICU treatment time was 162.50±49.90min,87.42±38.14mL,OmL and Oh in EVAR group compared with 255.96±48.14min,404.5±361.23mL, 357.97±460.78mL and 12h in OSR group(P<0.05).The perioperative survival rate and accumulative survival rate of EVAR group was no diffrence compared with OSR group(P>0.05).There are 30 complicated abdominal aortic aneurysms,3(10.0%) patients were treated with EVAR,27(90%) patients were treated with OSR, there was 1 death in OSR group,the rest survived well,the perioperative survival rate and accumulative survival rate have no difference between the two groups.Conclusion:1.Endovascular repair compared with traditional open surgery, has the advantage of fewer traumas,less blood loss, and rapid recovery, is a priority choice for elderly patients and high-risk patients with abdominal aortic aneurysms.2.The young and low-risk patients could choose the traditional open surgical repair first.3.The traditional open surgical repair is more competitive in the treatment of complex abdominal aortic aneurysms.