Clinical outcomes of chimney endovascular aneurysm repair versus open surgical repair for short-neck abdominal aortic aneurysms.

IF 1.6 4区医学 Q2 SURGERY

Surgery Today Pub Date : 2025-07-25 DOI:10.1007/s00595-025-03104-z

Shinichiro Yoshino, Koichi Morisaki, Daisuke Matsuda, Jun Okadome, Ryoichi Kyuragi, Shinichi Tanaka, Kohei Ueno, Yusuke Fujioka, Go Kinoshita, Kentaro Inoue, Kenichi Honma, Takahiro Omine, Terutoshi Yamaoka, Hiroyuki Ito, Tomoharu Yoshizumi

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引用次数: 0

Abstract

Purpose: To compare the outcomes of chimney endovascular aneurysm repair (Ch-EVAR) and open surgical repair (OSR) for abdominal aortic aneurysm (AAA) in consideration of the lack of comparative evidence.

Methods: The subjects of this retrospective study were patients who underwent elective Ch-EVAR or OSR for short-neck AAAs between 2013 and 2020 at five vascular centers. The primary endpoint was 30-day mortality and the secondary endpoints were postoperative complications and midterm clinical outcomes, including renal function changes, reintervention, overall survival, and aneurysm-related mortality.

Results: We analyzed 38 Ch-EVARs and 42 OSRs. The 30-day mortality rates were 2.6 and 2.4% in the Ch-EVAR and OSR groups, respectively (P = 1.00). The acute kidney injury incidence was higher in the OSR group than in the Ch-EVAR group (P < 0.01). The freedom from reintervention rate at 5 years was lower in the Ch-EVAR group than in the OSR group (81.0% vs. 100%, P = 0.04). Other midterm clinical outcomes did not differ between the groups.

Conclusions: Ch-EVAR may be a feasible treatment option for short-neck AAA; however, it should be limited to patients at high operative risk for OSR, considering the concern about its long-term durability.

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短颈腹主动脉瘤烟囱腔内修复与开腹手术修复的临床效果。

目的：在缺乏比较证据的情况下，比较烟囱腔内动脉瘤修复术（Ch-EVAR）和开放式手术修复术（OSR）治疗腹主动脉瘤（AAA）的疗效。方法：本回顾性研究的对象是2013年至2020年间在五个血管中心接受选择性Ch-EVAR或OSR治疗短颈AAAs的患者。主要终点是30天死亡率，次要终点是术后并发症和中期临床结果，包括肾功能改变、再干预、总生存期和动脉瘤相关死亡率。结果：我们分析了38例Ch-EVARs和42例osr。Ch-EVAR组和OSR组30天死亡率分别为2.6和2.4% （P = 1.00）。OSR组急性肾损伤发生率高于Ch-EVAR组(P)。结论：Ch-EVAR可能是短颈AAA的一种可行的治疗方案；然而，考虑到OSR的长期持久性，它应仅限于手术风险高的患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgery Today 医学-外科

CiteScore

4.90

自引率

4.00%

发文量

208

审稿时长

1 months

期刊介绍： Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it"). The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.