Propensity Score and Long-Term Survival Results after Open versus Endovascular Treatment of Abdominal Aortic Aneurysm

Background: There are not many publications on the long-term results of surgical treatment for abdominal aortic aneurysm (AAA) comparing open repair (OR) and endovascular aneurysm repair (EVAR). Method: Using a propensity score (PS), we matched cohorts which were eligible for both types of treatment and underwent an elective surgical procedure for infrarenal AAA between 2002 and 2008. The endpoint of the study was long-term survival without re-intervention. Results: From a total of 442 patients treated from 2002 to 2008, we identified 140 patients of whom 72 received a tube graft and 68 were treated by EVAR. Median observation time was 5 years (0.04-10.3). Mortality was zero in the EVAR group and 1% in the OR group, with cumulative survival after 5 and 10 years being 82 (79%) in the OR group and 80 (58%) in the EVAR group. Three patients (4%) out of 72 with open surgery and 23 patients (34%) from the EVAR group had to undergo a repeat surgery. Conclusion: Both procedures are safe methods to eliminate aneurysms. However, the high rate of re-interventions or conversions in the EVAR group has to be considered in the selection of treatment.