Open surgery or endovascular treatment of the abdominal aortic aneurysm quality assurance is urgently needed

Purpose. The endovascular treatment of the abdominal aortic aneurysm (AAA) seemed to promise great advantages over the open surgery. The current resul ts do not show an improvement compared to the conventional therapy. New kin ds of complications have appeared. Their significance especially in the lon gterm course cannot be assessed today because sufficient clinical data are missing. Methods. Between 1991 and 1997, 784 patients were electively operated on fo r infrarenal AAA. The clinical data of these patients were analysed retrosp ectively and compared to the current results of endovascular surgery in the literature. Results. In the 784 patients treated by conventional surgery the mortality was 2,4 %, the morbidity was 20,3 %. The mortality of endovascular treatmen t ranged between 0 and 8,9 %, the morbidity was 20 to 74 %. Endoleaks exist ed in up to 32 % of patients, and up to 21 % of interventions were initiall y not successful. The mortality of conversion to open surgery was reportedl y amounting 43 %. Conclusion. To confirm new standards in the therapy of AAA an overall quali ty assurance of endovascular and open surgery is necessary. Additionally ra ndomised studies have to be demanded. Only that way the indications of both methods can be based upon scientific facts.