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BioMed Research International
Volume 2016, Article ID 7893413, 7 pages
http://dx.doi.org/10.1155/2016/7893413
Research Article

Abdominal Aortic Aneurysm Repair: Results from a Series of Young Patients

1Vascular and Endovascular Surgery Unit, Department of Surgery “Paride Stefanini”, Policlinico Umberto I, “Sapienza” University of Rome, 00161 Rome, Italy
2Vascular and Endovascular Surgery Unit, Department of Medicine Surgery and Neurological Sciences, Policlinico Le Scotte, University of Siena, 53100 Siena, Italy

Received 27 June 2016; Revised 19 August 2016; Accepted 4 September 2016

Academic Editor: George N. Kouvelos

Copyright © 2016 Pasqualino Sirignano et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives. To compare durability and survival after endovascular aneurysm repair (EVAR) and open repair (OR) of abdominal aortic aneurysms (AAAs) in young patients. Material and Methods. A retrospective study was conducted between 2005 and 2014 on all consecutive patients of 60 years of age or younger. Measures considered for analysis were reintervention related to AAA, laparotomy and access vessel injury during EVAR, and all-cause mortality during hospitalization and follow-up. Results. Seventy out of 119 patients were treated by OR (58.8%) and 49 (41.2%) by EVAR, 9 in off-label fashion (18.3%). Technical success was achieved in all cases. No AAA-related death was recorded. Overall in-hospital mortality was zero and the reintervention rate was 2.5% (3/119: 1/70 OR, 2/49 EVAR, ). There is no death at 30-day or 1-year follow-up. Thirty-day reintervention rate was 1.6% (2/119; 0/70 OR, 2/49 EVAR, ), while the 1-year rate was 2.5% (3/119; 1/70 OR, 2/49 EVAR, ). At the mean follow-up of 56.8 ± 42.7 months, mortality and reintervention rates were 5.8% (7/119; 3/70 OR, 4/49 EVAR, ) and 10% (12/119; 8/70 OR, 4/49 EVAR, ), respectively. The overall reintervention rate, mortality, and freedom from adverse events did not differ between the two groups. No differences in outcome were recorded between patients treated by EVAR in on-label versus off-label fashion. Conclusion. Our (albeit limited) experience suggests that, in an unselected young patient population undergoing elective AAA repair, OR or EVAR can be performed safely with similar immediate and long term outcomes.