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Surgery Today
Published in: Surgery Today 10/2023

Open Access 24-03-2023 | Aneurysm | Original Article

Japanese single-center experience of abdominal aortic aneurysm repair over 20 years: should open or endovascular aneurysm repair be performed first?

Authors: Katsuhiro Yamanaka, Mari Hamaguchi, Shunya Chomei, Taishi Inoue, Atsunori Kono, Takanori Tsujimoto, Yojiro Koda, Hidekazu Nakai, Atsushi Omura, Takeshi Inoue, Masato Yamaguchi, Koji Sugimoto, Kenji Okada

Published in: Surgery Today | Issue 10/2023

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Abstract

Purpose

The present study analyzed the outcomes of our experience with abdominal aortic aneurysm (AAA) repair over 20 years using endovascular aortic repair (EVAR) with commercially available devices or open aortic repair (OAR) and reviewed our surgical strategy for AAA.

Methods

From 1999 to 2019, 1077 patients (659 OAR, 418 EVAR) underwent AAA repair. The OAR and EVAR groups were compared retrospectively, and a propensity matching analysis was performed.

Results

EVAR was first introduced in 2008. Our strategy was changed to an EVAR-first strategy in 2010. Beginning in 2018, this EVAR-first strategy was changed to an OAR-first strategy. After propensity matching, the overall survival in the OAR group was significantly better than that in the EVAR group at 10 years (p = 0.006). Two late deaths due to AAA rupture were identified in the EVAR group, although there were no significant differences between the OAR and EVAR groups with regard to the freedom from AAA-related death at 10 years. The rate of freedom from aortic events at 10 years was significantly higher in the OAR group than in the EVAR group (p < 0.0001).

Conclusion

The rates of freedom from AAA-related death in both the OAR and EVAR groups were favorable, and the rate of freedom from aortic events was significantly lower in the EVAR group than in the OAR group. Close long-term follow-up after EVAR is mandatory.
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Metadata
Title
Japanese single-center experience of abdominal aortic aneurysm repair over 20 years: should open or endovascular aneurysm repair be performed first?
Authors
Katsuhiro Yamanaka
Mari Hamaguchi
Shunya Chomei
Taishi Inoue
Atsunori Kono
Takanori Tsujimoto
Yojiro Koda
Hidekazu Nakai
Atsushi Omura
Takeshi Inoue
Masato Yamaguchi
Koji Sugimoto
Kenji Okada
Publication date
24-03-2023
Publisher
Springer Nature Singapore
Published in
Surgery Today / Issue 10/2023
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-023-02663-3

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