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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
A Journal on Vascular and Endovascular Surgery
Italian Journal of Vascular and Endovascular Surgery 2011 September;18(3):167-73
Aneurysms of the abdominal aorta: results and considerations for their treatment using extraperitoneal and endovascular approach
Apostolou D., Mangiacotti B., Scovazzi P., Novali C.
Vascular Surgery Department, Santa Croce Hospital, Cuneo, Italy
Aim. Endovascular treatment of the aneurysms of the abdominal aorta (AAA) has reduced the number of days spent in intensive care and of hospitalization. This study compares the short-term results (first 30 days) and the costs of endovascular technology with those of reparation via extraperitoneal mini-approach.
Methods. In the period comprised between January 2004 and August 2010 we have treated 691 patients for AAA. Two hundred and twenty-five patients (203 male and 22 female) were treated surgically via the extraperitoneal approach (32.5%) and 105 (96 men and 9 women) via endoprosthesis placement (15.2%). The average age of patients undergoing open surgery was 75 years, while the average age of those undergoing endovascular treatment was 77 years. Parameters linked to the operation and hospital admission have been taken into consideration, as well as costs of the various techniques, hospitalization and follow-up care.
Results. The difference in the number of complications during the operation or post-operatively between the two groups is not significant. Patients requiring intensive care stay was higher in the open surgery group (41%), but the overall number of days spent in hospital were similar in the two groups (7 for open surgery and about 6 for endovascular treatment). Health costs were lower for patients undergoing open surgery.
Conclusion. In our case study extraperitoneal treatment is similar in terms of short term complications and hospitalization to endovascular treatment, but with noticeably lower costs. Open surgery with extraperitoneal approach for AAA represents a valid alternative to endovascular treatment.