Outcomes of endovascular treatment of infrarenal abdominal aortic aneurysms: A single centre experience

Background and aim: This study aimed to compare the efficacy and safety of endovascular repair and open aortic repair (OAR) in the treatment of infrarenal abdominal aortic aneurysm (AAA) using data from the National Scientific Center of Surgery named after A.N. Syzganov. Methods: A retrospective analysis was conducted on 105 patients treated between 2018 and 2023: 80 underwent endovascular repair and 25 received OAR. Results: Endovascular repair was associated with shorter hospital stays (13 versus 18.6 days; p=0.001), shorter time in the intensive care unit (1.34 versus 2.28 days; p=0.024), shorter operation duration (180 versus 289 minutes; p=0.001), less time for aortic clamping, reduced blood loss, and fewer transfusion requirements. Although the endovascular repair group had higher rates of comorbidities (p<0.005), postoperative complications were similar between the groups (p≥0.005). In-hospital mortality occurred only in the endovascular repair group, while the five-year survival rate was slightly higher in the OAR group (80% versus 76.25%), though not statistically significant (p≥0.005). Despite the higher rate of comorbidities in the endovascular intervention group, the incidence of postoperative complications was comparable in both groups. Conclusions: Both approaches have their advantages and limitations, and the choice of method should be based on individual patient characteristics and clinical situation. The practical significance of the study was to provide an evidence base for informed choice between endovascular and OAR in treating infrarenal AAA, and a personalized approach to surgical planning considering individual patient characteristics and risk factors.