부산대학교 도서관

Byline: J. J. Siracuse, M. L. Schermerhorn, A. J. Meltzer, M. H. Eslami, J. A. Kalish, D. Rybin, G. Doros, A. Farber, the Vascular Study Group of New England Abstract Background In randomized trials endovascular aortic aneurysm repair (EVAR) has been shown to have superior perioperative outcomes compared with open aneurysm repair (OAR). However, outcomes in patients at low risk of complications are unclear and many surgeons still prefer OAR in this cohort. The objective was to analyse perioperative and longer-term outcomes of OAR and EVAR in this low-risk group of patients. Methods All elective infrarenal EVARs and OARs in the Vascular Study Group of New England database were reviewed from 2003 to 2014. The Medicare scoring system was used to identity patients at low risk of perioperative complications and death. Perioperative and longer-term outcomes were analysed in this cohort. A Kaplan-Meier plot was constructed for evaluation of longer-term survival. Further propensity matching and multivariable analysis were performed to analyse additional differences between the two groups. Results Some 1070 patients who underwent EVAR and 476 who had OAR were identified. Mean(s.d.) age was 67ae3(5ae7) and 65ae1(6ae3) years respectively (P Conclusion In patients predicted to be at low risk of perioperative death following aneurysm repair, EVAR resulted in fewer perioperative complications than OAR. However, perioperative mortality, reinterventions and survival rates in the longer term appeared similar between endovascular and open repair.