Abstract
Objectives: Abdominal aortic aneurysm (AAA) in high risk patient could be repaired by endovascular aneurysm repair (EVAR) because of its less invasiveness. We evaluated the change of AAA patient’s characteristics before and after the introduction of EVAR.
Methods: We encountered 328 patients with AAA from January 2000 through December 2010. For 293 elective cases, we compared the patient’s characteristics such as age, frequency of coronary artery disease (CAD), stroke, and impaired daily activity (walking with a stick or worse) between patients before (pre group, n=180) and after (post group, n=113) the introduction of EVAR. In addition, post group was divided into open repair patients (post-open group, n=32) and EVAR patients (EVAR group, n=81). We also analyzed the proportion of cases of ruptured AAA during this period.
Results: Patient age did not differ between pre and post groups, however post group patients had a significantly higher incidence of CAD, stroke and impaired daily activity. Post-open group were younger than the EVAR group (p=0.005), with less risks for surgery. Mortality rate did not differ between three groups. Post operative admission period was significantly shorter in the EVAR (10.6 days) group than the pre (20.4 days) or post-open (18.1 days) groups (p<0.001). The proportion of ruptured AAA decreased during the study period, from 12% in the pre-EVAR period to 8% in the post-EVAR era, however the difference did not reach to statistical significance.
Conclusion: The mortality rate did not increase even the patient’s characteristics became high risk by the introduction of EVAR. Ruptured AAA might decrease with the wider applications of EVAR in the future.
