EVAR suitability is not a predictor for early and midterm mortality after open XXXX repair.

@entity1 @entity439 @entity397 @entity1755
OBJECTIVE: The reported mortality @entity439 repair (eEVAR) compared with open repair in @entity1 with a @entity1755 ( @entity1755 ), as observed in observational studies, might be flawed by selection bias based on anatomical suitability for eEVAR. In the present study, we compared mortality in EVAR suitable versus non-EVAR-suitable @entity1 with a @entity397 who were all treated with conventional open repair. MATERIALS AND METHODS: In all @entity1 presenting with a suspected @entity1755 , computed tomography angiography (CTA) scanning was performed. All consecutive @entity1 with a confirmed @entity1755 on preoperative CTA scan and treated with open repair between April 2002 and April 2008 were included. Anatomical suitability for eEVAR was determined by two blinded independent reviewers. Outcomes evaluated were mortality (intra-operative, 30-day, and 6-month), morbidity, complications requiring re-intervention and length of hospital stay. RESULTS: A total of 107 consecutive @entity1 presented with a @entity1755 and underwent preoperative CTA scanning. In 25 @entity1 , eEVAR was performed. In the 82 @entity1 who underwent open repair, CTA showed an EVAR-suitable @entity1755 in 33 @entity1 (41.8%) and a non-EVAR-suitable @entity1755 in 49 @entity1 . Thirty-day and 6-month mortality rate was 15/33 (45.5%; 95% confidence interval (CI) 28.1-63.7) and 18/33 (54.5%; 95% CI 36.4-71.9) in the EVAR-suitable group versus 24/49 (49.0%; 95% CI 34.4-63.7) (P=0.75) and 29/49 (59.2%; 95% CI 44.2-73.0) (P=0.68) in the non-EVAR-suitable group, respectively. CONCLUSIONS: The present study suggests that anatomical suitability for EVAR is not associated with lower early and midterm mortality in @entity1 treated with open @entity397 repair. Therefore, the reported reduction in mortality between eEVAR and open repair is unlikely due to selection bias based on anatomical AAA configuration.
