Document Type

Project

Publication Date

2024

Abstract

Background:

Abdominal Aortic Aneurysms (AAA) have two main interventions when they reach an aneurysmal sac diameter of at least 5 cm.: Endovascular aneurysm repair (EVAR) and open-repair surgery [3]. This literature review evaluates the risks and benefits to both interventions to determine which method is most beneficial for patients over 60 years-old.

Methods:

A conducted a systemic review and meta-analysis, research in randomized controlled clinical trials, trial reviews in Pubmed searched “EVAR vs open-repair AAA”. A systematic review and meta-analysis of published peer review literature was conducted. The PubMed database was searched with keywords “EVAR vs open-repair AAA”, yielding 651 results from the years 2003-2022. The exclusion criteria used in this review was to include studies that looked at the long term outcomes of each procedure instead of focusing primarily on the preoperative phase. Another factor was including studies towards reviews directly comparing the two treatment methods and the risks/benefits.

Results:

Randomized controlled trial with 15 year follow up with 1252 patients aged 60 years or older assigned EVAR (n=626) and open repair (n=626) based on anatomical suitability. Patients in the EVAR group had a lower mortality after 0-6 months. Beyond 8 years of follow-up open-repair had a significantly lower mortality rate. Based on the 11 articles reviewed, 7 out of 10 studies favored OAR over EVAR, and 1 study remained undecided.

Conclusion:

Open wound surgery has more long term survival/sustainable benefits compared to EVAR due to the risk of graft complications, increased reintervention, and heavy surveillance in the long term. OAR should be the first method of treatment if the patient is a proper candidate for OAR over EVAR.

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