期刊
JOURNAL OF VASCULAR SURGERY
卷 75, 期 1, 页码 81-+出版社
MOSBY-ELSEVIER
DOI: 10.1016/j.jvs.2021.06.031
关键词
Aortic aneurysm; Abdominal aortic aneurysm; Endovascular repair; Operative surgical procedures; Mortality
In the Netherlands, JRAAA patients treated with open surgical repair have higher rates of major and minor complications, along with a higher risk of early mortality compared to those treated with complex endovascular repair.
Background: Juxtarenal abdominal aortic aneurysms (JRAAAs) can be treated either with open surgical repair (OSR) including suprarenal clamping or by complex endovascular aneurysm repair (cEVAR). In this study, we present the comparison between the short-term mortality and complications of the elective JRAAA treatment modalities from a national database reflecting daily practice in The Netherlands. Methods: All patients undergoing elective JRAAA open repair or cEVAR (fenestrated EVAR or chimney EVAR) between January 2016 and December 2018 registered in the Dutch Surgical Aneurysm Audit (DSAA) were eligible for inclusion. Descriptive perioperative variables and outcomes were compared between patients treated with open surgery or endovascularly. Adjusted odds ratios for short-term outcomes were calculated by logistic regression analysis. Results: In all, 455 primary treated patients with JRAAAs could be included (258 OSR, 197 cEVAR). Younger patients and female patients were treated more often with OSR vs cEVAR (72 +/- 6.1 vs 76 +/- 6.0; P<.001 and 22% vs 15%; P=.047, respectively). Patients treated with OSR had significantly more major and minor complications as well as a higher chance of early mortality (OSR vs cEVAR, 45% vs 21%; P<.001; 34% vs 23%; P=.011; and 6.6% vs 2.5%; P=.046, respectively). After logistic regression with adjustment for confounders, patients who were treated with OSR showed an odds ratio of 3.64 (95% confidence interval [CI], 2.25-5.89; P<.001) for major complications compared with patients treated with cEVAR, and for minor complications, the odds ratios were 2.17 (95% CI, 1.34-3.53; P=.002) higher. For early mortality, the odds ratios were 3.79 (95% CI, 1.26-11.34; P=.017) higher after OSR compared with cEVAR. Conclusions: In this study, after primary elective OSR for JRAAA, the odds for major complications, minor complications, and short-term mortality were significantly higher compared with cEVAR.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据