Analysis of Prognostic Factors for Postoperative Complications and Reinterventions After Open Surgical Repair and Endovascular Aneurysm Repair in Patients With Abdominal Aortic Aneurysm

Abstract

A retrospective, single-center review was performed between 2006 and 2017. Although the operative mortality rate was the same (0.5%) for both groups, the 405 patients who had undergone endovascular aortic aneurysm repair (EVAR) had experienced significantly fewer postoperative complications (13%) than had the 176 patients who had undergone open surgical repair (OSR) for infrarenal abdominal aortic aneurysms (36%). Patients who had undergone hostile neck EVAR had a significantly lower 5-year reintervention-free survival rate (63%) than the patients who had undergone favorable neck EVAR (83%) and those who had undergone OSR (86%). Patients with hostile neck EVAR also had a significantly lower 5-year overall survival rate (52%) compared with favorable neck EVAR (73%) and OSR (79%). Age, hemodialysis, and modified frailty index (mFI) were the risk factors for complications, increased reintervention, and decreased 5-year survival on multivariate analysis. Age, mFI, hemodialysis, and hostile neck anatomy are useful predictors for reintervention and 5-year survival and could be useful for selecting treatment between OSR and EVAR.