[Abdominal aortic aneurysms--endovascular and open surgery]

Abstract

Background: In Norway, repair of abdominal aortic aneurysms is performed in more than 800 patients annually. Open repair is an established procedure, but an increasing number of patients have undergone endovascular repair during the last decades. The paper delivers an up to date discussion of infrarenal abdominal aortic aneurysm repair.

Materials and methods: A systematic search was performed in Pubmed and literature containing the search terms "abdominal aortic aneurysm" and "mortality" (from 2004 to 2009) was retrieved. The review is based on randomized, multi-centre and registry studies examining complications and mortality in endovascular and open repair.

Results: Perioperative mortality is lower in endovascular repair. The initial survival benefit is not sustained over time. The mortality rate is still high in ruptured abdominal aortic aneurysms, but endovascular repair may improve mortality in selected patients.

Interpretation: Even though perioperative mortality associated with endovascular repair is lower than that of open repair, questions concerning benefit and selection of patients are still left unanswered.