Key result
Standard operative repair for abdominal aortic aneurysms > 5 cm in good-risk patients should achieve operative mortality <5% and 1-year survival >90%, setting the standard for newer endograft techniques.
Why the study?
What are the benchmark outcomes for standard operative repair of abdominal aortic aneurysms that newer endograft techniques must meet?
What are the benchmark outcomes for standard operative repair of abdominal aortic aneurysms that newer endograft techniques must meet?
Standard operative repair for AAA > 5 cm in good-risk patients sets a high benchmark (operative mortality < 5%, 1-year survival > 90%) that newer endovascular techniques must meet or exceed.
Establishes open-repair benchmarks for endograft trials; leaves open whether contemporary endovascular results meet these thresholds in good-risk patients.
Surgical treatment of abdominal aortic aneurysm (AAA) is being challenged by newer, minimally invasive therapies. Such new treatment strategies will need to prove themselves against concurrent results of standard operative AAA repair, within defined medical risk and aneurysm morphological categories. We review the natural history of AAAs, the medical risk levels for elective AAA repair, aneurysm morphology and its impact on operative mortality, the issue of high-risk patient treatment, and the current standard of care for AAAs based on single-center, multicenter, and population-based statistics. In good-risk patients, aneurysms > 5 cm in diameter are best treated by replacement with a prosthetic graft. Operative mortality should be < 5% and 1-year survival > 90%. Aortic endograft techniques must meet or exceed these standards if they are to supplant standard surgical repair.
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Zarins et al. (1997) conducted a review in Abdominal aortic aneurysm (AAA). Standard operative AAA repair (prosthetic graft replacement) vs. Aortic endograft techniques was evaluated. Standard operative repair for abdominal aortic aneurysms > 5 cm in good-risk patients should achieve operative mortality <5% and 1-year survival >90%, setting the standard for newer endograft techniques.
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