Michele Piazza, Peter Gloviczki, Ying Huang, Manju Kalra, Audra A Duncan, Gustavo S Oderich, William S Harmsen, Thomas C Bower
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引用次数: 7
Abstract
Objective: To compare outcomes of abdominal aortic aneurysm repairs before and after the endovascular era.
Methods: Group A (1997-1998) included 331 patients, 321 (97%) with open repair (OR) and 10 (3%) with endovascular aneurysm repair (EVAR). Group B (2007-2008) included 330 patients, 136 (41%) with OR and 194 (59%) with EVAR.
Results: Patients in Group B were older (74 ± 8.5 vs 73 ± 7.0 years, P = .02), had higher comorbidity scores (8.3 ± 4.8 vs 7.5 ± 4.6, P = .04), shorter hospitalization (5.1 ± 6.4 vs 9.8 ± 6.3, P < .001), less intensive care unit days than in Group B (0.9 ± 2.1 vs 2.2 ± 2.7, P < .001). Early mortality was 0.6% in both groups. Two-year survival was similar (88% vs 89%), with less reinterventions in Group A (4% vs 17%, P = .004). OR patients had similar 30-day mortalities (0.9% vs 0.7%, P = .89).
Conclusion: EVAR and OR have low mortalities. However, in the post-EVAR era we treat older patients with more comorbidities, hospitalization is shorter, and intensive care unit days are less; interventions in EVAR are, however, high.
目的:比较腔内手术前后腹主动脉瘤的修复效果。方法:A组(1997 ~ 1998年)331例，其中开放性动脉瘤修复术321例(97%)，血管内动脉瘤修复术10例(3%)。B组(2007-2008)330例患者，136例(41%)为OR, 194例(59%)为EVAR。结果:B组患者年龄较大(74±8.5 vs 73±7.0岁，P = 0.02)，共病评分较高(8.3±4.8 vs 7.5±4.6,P = 0.04)，住院时间较短(5.1±6.4 vs 9.8±6.3,P < 0.001)，重症监护天数少于B组(0.9±2.1 vs 2.2±2.7,P < 0.001)。两组的早期死亡率均为0.6%。2年生存率相似(88% vs 89%)， A组再干预较少(4% vs 17%， P = 0.004)。OR组患者30天死亡率相似(0.9% vs 0.7%， P = 0.89)。结论:EVAR和OR病死率低。然而，在evar后时代，我们治疗的老年患者合并症更多，住院时间更短，重症监护天数更少;然而，EVAR的干预措施很高。
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