Faculty Collaboration Database

Outcomes and Cost-Analysis of Open Versus Endovascular Abdominal Aortic Aneurysm Repair in a Developing Country: A 15-year Experience at a Tertiary Medical Center. Ann Vasc Surg 2023 Mar;90:58-66

Date

10/30/2022

Pubmed ID

36309170

DOI

10.1016/j.avsg.2022.10.005

Scopus ID

2-s2.0-85143634918 (requires institutional sign-in at Scopus site)   2 Citations

Abstract

BACKGROUND: Endovascular aortic aneurysm repair (EVAR) has become the most common procedure for treating abdominal aortic aneurysms based on multiple studies conducted in the western world. The implication of such findings in developing countries is not well demonstrated. The objective of this study was to compare medical outcomes and costs of EVAR and open surgical repair (OSR) in a developing country.

METHODS: This is a retrospective study of all patients undergoing elective abdominal aortic aneurysm repair between 2005 and 2020 at a tertiary medical center in a developing country. Medical records were used to retrieve demographics, comorbidities, and perioperative complications. Medical records were also used to provide data on the need of reintervention, date of last follow-up, and mortality.

RESULTS: The study included a total of 164 patients. Median follow-up time was 41 months. The mean age was 69.9 +/- 7.84 years and 90.24% (n = 148) of patients were males. Regarding long-term mortality outcomes, no significant difference was detected between both groups; OSR patients had a survival rate of 91.38% and 74.86% at 5 and 10 years, compared to 77.29% and 56.52% in the EVAR group (P value = 0.10). Both groups had comparable long-term reintervention rates (P value = 0.334). The OSR group was charged significantly less than the EVAR group ($27,666.35 vs. $44,528.04, P value = 0.008).

CONCLUSIONS: OSR and EVAR have comparable survival and reintervention outcomes. Unlike what was reported in developed countries, patients undergoing OSR in countries with low hospital stay costs incur lower treatment costs.

Author List

Al Tannir AH, Chahrour MA, Chamseddine H, Assi S, Boyajian T, Haddad FF, Hoballah JJ

Author

Abdul Hafiz Al Tannir MD Postdoctoral Fellow in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Aortic Aneurysm, Abdominal
Blood Vessel Prosthesis Implantation
Developing Countries
Endovascular Procedures
Female
Health Care Costs
Humans
Male
Middle Aged
Postoperative Complications
Retrospective Studies
Risk Factors
Time Factors
Treatment Outcome