Physiological comparison of open and endovascular aneurysm repair

Background: This prospective study compared morbidity and mortality rates f ollowing conventional and endovascular abdominal aortic aneurysm (AAA) repa ir using a physiological scaring system. Methods: Between December 1994 and November 1997, 104 elective open aneurys m repairs and 49 endovascular aneurysm repairs were performed. These patien t cohorts were compared using the Portsmouth predictor equation (P-POSSUM) scoring system. Data collected prospectively from patient. notes were used to obtain physiological and operative severity scares which were analysed t o compare expected and observed mortality and morbidity rates. Results: There were three deaths (6 per cent) in the endovascular AAA repai r group and 17 (16 per cent) in the conventional aneurysm repair group, whe reas the P-POSSUM formulae predicted mortality rates of 8 and 19 per cent r espectively. Although the mean physiological scores were similar for both g roups (endovascular 20.8 versus conventional 20.1), the operative severity score was significantly greater in the conventional group (26.3 versus 19.7 ; P < 0.001). Conclusion: In this study open aortic aneurysm repair bad a higher operativ e severity than endovascular repair, which was reflected in the increased m ortality rate.