Comparison between Stent Grafting and Open Surgery in Thoracic Aortic Aneurysms

Abstract

Objectives: Early and mid-term results of stent graft (SG) treatment for thoracic aortic aneurysms (thoracic endovascular aneurysm repair; TEVAR) were retrospectively compared with open surgical treatment.
Methods: The records of 213 patients in whom single thoracic aortic aneurysm repairs had been performed in our department from January 2006 through August 31 2009 were reviewed. Acute aortic dissection was excluded. Each case was reviewed for indications for TEVAR from an anatomical standpoint. Among 62 cases in which TEVAR was indicated, 30 cases (the SG group) were treated by TEVAR and 32 cases were treated by open surgery (the OP group). Early and mid-term results were analyzed retrospectively in both groups.
Results: There were no operative deaths in either group. The SG group demonstrated significantly less operative bleeding, shorter operative time, and shorter postoperative hospital stay compared with the OP group. There were 3 deaths in the SG group and 4 in the OP group which occurred within an average of 656.4 days during the follow up period. The 3-year actuarial survival rate was 88.7% in the SG group and 87.1% in the OP group, and there were no significant differences between the groups.
Conclusion: Although early and mid-term results of TEVAR and open surgery were similar, TEVAR is generally less invasive and may be preferable for high-risk patients compared with open surgical repair.