Endovascular Aortic Aneurysm Repair Versus Open Surgical Repair For Abdominal Aortic Aneurysms: A Meta-analysis

Objective Evaluate abdominal aortic aneurysm repair cavity(endovascular aortic aneurysm repair,EVAR)and traditional open surgery(open surgical repair,OSR)in abdominal aortic aneurysm(abdominal aortic aneurysms,AAA)long-term efficacy of treatment,to evaluate the treatment AAA EVAR long-term safety and efficacy.Methods Search on the literature published on VIP,CNKI,Wanfang database,CBM,Google academic search,PubMed,Web of Science,Medline database and other websites about the difference in long-term efficacy between OSR and EVAR in the treatment of AAA until December 2018.Literature was screened according to inclusion and exclusion criteria,and data were extracted for Meta analysis.Results A total of 6 articles were included,all in English and RCT literature.There were a total of 4478 patients,including 2226 in the open group and 2252 in the interventional group.Meta analysis results: there was no statistical difference in the total postoperative mortality(OR=0.97,95%CI: 0.85,1.10,P>0.05)and the total aneurysm-related mortality(OR=1.20,95%CI: 0.97,1.45,P>0.05)between the open group and the interventional group,and there was statistical difference in the re-intervention rate(OR=0.58,95%CI: 0.49,0.68,P<0.05).Conclusion Endovascular repair is superior to open surgery in the early treatment of abdominal aortic aneurysm.It can be said that endovascular repair has the advantages of minimally invasive,less postoperative complications and faster recovery of patients.However,the long-term efficacy of endovascular repair in the treatment of abdominal aortic aneurysm is not better than that of open surgery,which is associated with more long-term complications and higher re-intervention rate after endovascular repair.Therefore,long-term follow-up should be conducted after EVAR.