The Justification of Open Surgical Repair for an Abdominal Aortic Aneurysm: A Retrospective Comparison of Outcomes of Endovascular Aneurysm Repair and a Brief Review of the Literature
<b>Background:</b> Abdominal aortic aneurysms (AAAs) are life-threatening conditions that require timely intervention to prevent rupture. Endovascular aneurysm repair (EVAR) is preferred due to faster recovery and lower perioperative risk; however, intraoperative failure and long-term co...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2025-03-01
|
| Series: | Life |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2075-1729/15/3/426 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850280136305278976 |
|---|---|
| author | Ümit Arslan Ziya Yıldız İbrahim Pir Çağrı Aykut |
| author_facet | Ümit Arslan Ziya Yıldız İbrahim Pir Çağrı Aykut |
| author_sort | Ümit Arslan |
| collection | DOAJ |
| description | <b>Background:</b> Abdominal aortic aneurysms (AAAs) are life-threatening conditions that require timely intervention to prevent rupture. Endovascular aneurysm repair (EVAR) is preferred due to faster recovery and lower perioperative risk; however, intraoperative failure and long-term complications highlight the continued significance of open surgical repair (OSR) and the need for improved risk assessment. <b>Methods:</b> This retrospective study analyzed data from 210 patients who underwent EVAR (<i>n</i> = 163) or OSR (<i>n</i> = 47) at a single center. Clinical characteristics, complications, reintervention rates, and 30-day mortality were recorded. EVAR-to-OSR conversion and mortality predictors in AAA treatments were identified. <b>Results</b>: The overall mortality rate was 9.5% (20/210 patients), with 12 patients (7.3%) in the EVAR group and 8 patients (17%) in the OSR group (<i>p</i> = 0.085). Five patients required early and six required late conversion to open surgery. In follow-ups beyond 30 days, the reintervention rate for EVAR was higher (HR: 1.2, 95% CI: 0.4–3.6; <i>p</i> = 0.754). According to the multivariable analysis, rupture (<i>p</i> = 0.045), female sex (<i>p</i> = 0.018), body weight (<i>p</i> = 0.003), and aortic size index (<i>p</i> = 0.019) were significant predictors of mortality, whereas OSR was not (<i>p</i> = 0.212). <b>Conclusions</b>: Treatment optimization requires a balanced approach, integrating both EVAR and OSR based on patient-specific factors. Maintaining expertise in both techniques is essential to ensure the best possible outcomes, and OSR should remain a viable option when clinically indicated. |
| format | Article |
| id | doaj-art-4fa66e4a55744c5a876fb236f03d4a07 |
| institution | OA Journals |
| issn | 2075-1729 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Life |
| spelling | doaj-art-4fa66e4a55744c5a876fb236f03d4a072025-08-20T01:48:52ZengMDPI AGLife2075-17292025-03-0115342610.3390/life15030426The Justification of Open Surgical Repair for an Abdominal Aortic Aneurysm: A Retrospective Comparison of Outcomes of Endovascular Aneurysm Repair and a Brief Review of the LiteratureÜmit Arslan0Ziya Yıldız1İbrahim Pir2Çağrı Aykut3Department of Cardiovascular Surgery, Faculty of Medicine, Atatürk University, Erzurum 25030, TurkeyDepartment of Cardiovascular Surgery, Erzurum City Hospital, Erzurum 25040, TurkeyDepartment of Cardiovascular Surgery, Faculty of Medicine, Atatürk University, Erzurum 25030, TurkeyDepartment of Cardiovascular Surgery, Faculty of Medicine, Atatürk University, Erzurum 25030, Turkey<b>Background:</b> Abdominal aortic aneurysms (AAAs) are life-threatening conditions that require timely intervention to prevent rupture. Endovascular aneurysm repair (EVAR) is preferred due to faster recovery and lower perioperative risk; however, intraoperative failure and long-term complications highlight the continued significance of open surgical repair (OSR) and the need for improved risk assessment. <b>Methods:</b> This retrospective study analyzed data from 210 patients who underwent EVAR (<i>n</i> = 163) or OSR (<i>n</i> = 47) at a single center. Clinical characteristics, complications, reintervention rates, and 30-day mortality were recorded. EVAR-to-OSR conversion and mortality predictors in AAA treatments were identified. <b>Results</b>: The overall mortality rate was 9.5% (20/210 patients), with 12 patients (7.3%) in the EVAR group and 8 patients (17%) in the OSR group (<i>p</i> = 0.085). Five patients required early and six required late conversion to open surgery. In follow-ups beyond 30 days, the reintervention rate for EVAR was higher (HR: 1.2, 95% CI: 0.4–3.6; <i>p</i> = 0.754). According to the multivariable analysis, rupture (<i>p</i> = 0.045), female sex (<i>p</i> = 0.018), body weight (<i>p</i> = 0.003), and aortic size index (<i>p</i> = 0.019) were significant predictors of mortality, whereas OSR was not (<i>p</i> = 0.212). <b>Conclusions</b>: Treatment optimization requires a balanced approach, integrating both EVAR and OSR based on patient-specific factors. Maintaining expertise in both techniques is essential to ensure the best possible outcomes, and OSR should remain a viable option when clinically indicated.https://www.mdpi.com/2075-1729/15/3/426abdominal aortic aneurysmEVARopen surgery repairconversion to open surgeryrupturereinterventions |
| spellingShingle | Ümit Arslan Ziya Yıldız İbrahim Pir Çağrı Aykut The Justification of Open Surgical Repair for an Abdominal Aortic Aneurysm: A Retrospective Comparison of Outcomes of Endovascular Aneurysm Repair and a Brief Review of the Literature Life abdominal aortic aneurysm EVAR open surgery repair conversion to open surgery rupture reinterventions |
| title | The Justification of Open Surgical Repair for an Abdominal Aortic Aneurysm: A Retrospective Comparison of Outcomes of Endovascular Aneurysm Repair and a Brief Review of the Literature |
| title_full | The Justification of Open Surgical Repair for an Abdominal Aortic Aneurysm: A Retrospective Comparison of Outcomes of Endovascular Aneurysm Repair and a Brief Review of the Literature |
| title_fullStr | The Justification of Open Surgical Repair for an Abdominal Aortic Aneurysm: A Retrospective Comparison of Outcomes of Endovascular Aneurysm Repair and a Brief Review of the Literature |
| title_full_unstemmed | The Justification of Open Surgical Repair for an Abdominal Aortic Aneurysm: A Retrospective Comparison of Outcomes of Endovascular Aneurysm Repair and a Brief Review of the Literature |
| title_short | The Justification of Open Surgical Repair for an Abdominal Aortic Aneurysm: A Retrospective Comparison of Outcomes of Endovascular Aneurysm Repair and a Brief Review of the Literature |
| title_sort | justification of open surgical repair for an abdominal aortic aneurysm a retrospective comparison of outcomes of endovascular aneurysm repair and a brief review of the literature |
| topic | abdominal aortic aneurysm EVAR open surgery repair conversion to open surgery rupture reinterventions |
| url | https://www.mdpi.com/2075-1729/15/3/426 |
| work_keys_str_mv | AT umitarslan thejustificationofopensurgicalrepairforanabdominalaorticaneurysmaretrospectivecomparisonofoutcomesofendovascularaneurysmrepairandabriefreviewoftheliterature AT ziyayıldız thejustificationofopensurgicalrepairforanabdominalaorticaneurysmaretrospectivecomparisonofoutcomesofendovascularaneurysmrepairandabriefreviewoftheliterature AT ibrahimpir thejustificationofopensurgicalrepairforanabdominalaorticaneurysmaretrospectivecomparisonofoutcomesofendovascularaneurysmrepairandabriefreviewoftheliterature AT cagrıaykut thejustificationofopensurgicalrepairforanabdominalaorticaneurysmaretrospectivecomparisonofoutcomesofendovascularaneurysmrepairandabriefreviewoftheliterature AT umitarslan justificationofopensurgicalrepairforanabdominalaorticaneurysmaretrospectivecomparisonofoutcomesofendovascularaneurysmrepairandabriefreviewoftheliterature AT ziyayıldız justificationofopensurgicalrepairforanabdominalaorticaneurysmaretrospectivecomparisonofoutcomesofendovascularaneurysmrepairandabriefreviewoftheliterature AT ibrahimpir justificationofopensurgicalrepairforanabdominalaorticaneurysmaretrospectivecomparisonofoutcomesofendovascularaneurysmrepairandabriefreviewoftheliterature AT cagrıaykut justificationofopensurgicalrepairforanabdominalaorticaneurysmaretrospectivecomparisonofoutcomesofendovascularaneurysmrepairandabriefreviewoftheliterature |