外科ジャーナル

Long-Term Outcomes of Open Repair of Inflammatory and Atherosclerotic Abdominal Aortic Aneurysms

Abstract

Ala Elhelali, Edel P Kavanagh, Niamh M Hynes, Wael Tawfick M and Sherif Sultan

Background: Abdominal aortic aneurysms (AAA) are a common vascular disease mostly affecting those over the age of 65 years. Open surgical repair (OSR) is considered the gold standard for the treatment of AAA, however longterm mortality and morbidity still remain high in patients with inflammatory AAA, when compared to atherosclerotic AAA. The aim of this study was to evaluate long-term outcomes of both inflammatory and atherosclerotic AAA after OSR.

Methods: Out of 837 aortic interventions, 149 patients were identified as having undergone open surgical repair for AAA between 2003 and 2013. Of the 149 patients, histopathological data was available for 92 patients with open AAA repair. Kaplan-Meier curves were analysed to evaluate probability of survival.

Results: Patients with inflammatory AAA were younger (70 years) by an average of 2 years compared to atherosclerotic AAA (72 years). Morbidity and length of intensive care stay were insignificantly different in both groups. Inflammatory AAA were associated with higher all cause survival rate (82%) compared to atherosclerotic AAA (68%) (P=0.008) after ten years.

Conclusion: There was no difference in clinical outcomes between both atherosclerotic AAA and inflammatory AAA, which is due to the technique used. IAAA were associated with lower mortality rates and improved all cause survival at ten years post open surgical repair.