Early and Late Outcomes of Endovascular Aortic Aneurysm Repair versus Open Surgical Repair of an Abdominal Aortic Aneurysm: A Single-Center Study.

BACKGROUND: The objective of the study was to compare the treatment outcomes and cost of endovascular aortic aneurysm repair (EVAR) and open surgical repair (OSR) in patients with an abdominal aortic aneurysm (AAA) at a single center.

METHODS: Patients treated for an AAA at a single center between January 2007 and December 2012 were retrospectively identified and classified based on the treatment they received (EVAR or OSR). Patient demographics and in-hospital costs were recorded. Long-term survival was calculated using the Kaplan-Meier method.

RESULTS: During the study period, 401 patients with AAA were treated at Asan Medical Center. Among these cases, 226 were treated with EVAR (56%) and 175 received OSR (44%). The mean age of the EVAR group was higher than that of the OSR group (71.25 ± 7.026 vs. 61.26 ± 8.175, P < 0.001). The need for intraoperative transfusion and total length of in-hospital stay were significantly lower in the EVAR group (P < 0.001). The OSR group showed significantly reduced rates of overall mortality (P = 0.003), overall reintervention (P = 0.001), and long-term survival (63.98 ± 1.86 vs. 99.54 ± 3.17, P < 0.001). The OSR group was charged significantly less than the EVAR group ($12,879.21 USD vs. $18,057.78 USD, P < 0.001).

CONCLUSIONS: EVAR has advantages over OSR in terms of short-term mortality, in-hospital length of stay, and rates of perioperative transfusion. However, OSR is associated with better long-term survival, lower reintervention rates, and lower costs.