72306 - Favourable outcomes with a patient-focused treatment approach using open and endovascular techniques for abdominal aortic aneurysms in the modern era

Abstract Introduction The treatment of abdominal aortic aneurysms is rapidly changing from a tailored treatment approach including both open and endovascular surgery to a total endovascular approach. The evidence for that change of strategy is lacking. This study reports the modern short- and longterm outcome of a tailored treatment regime. Method All elective patients, referred to a tertiary aortic center with infra, juxta- and pararenal abdominal aortic aneurysms between 2012 and 2018 were included. 30-day, 90-day, 1-year and 5-year results regarding technical success, complications and survival were reported. The Student t-test or Mann-Whitney U test were used to compare continuous data, Chi-Square test to compare categorical data. Kaplan-Meier curves were used to present data on survival. Result 429 patients were referred during the time period. 114 patients (26.6%) were treated for complex abdominal aortic aneurysms. 193 (45.0%) patients (mean age 69.8 ± SD5.8) had open repair and 236 (55.0%) patients (mean age 74.9 ± SD6.6) had endovascular repair. In the open repair group, 78 (41.5%) had suprarenal clamp. In the endovascular group 17 (7.2%) received an fenestrated or branched device. Mortality at 30 days were 0.5% and 0.8% for open and EVAR respectively and at 90-days 0.5% and 2.1%, with no difference between groups. 5-year mortality was 15.5% and 31.8% for open and endovascular respectively. The pooled mortality was 24.5% at 5-years. Discussion A tailored aneurysm repair approach, where surgical technique is choosed based on patient-related factors as aneurysm-anatomy and physical status, may still be considered the optimal way to treat abdominal aortic aneurysms.