Mortality rates following endovascular repair of abdominal aortic aneurysms

Purpose:To present the perioperative and late mortality following endovascu lar repair (EVR) of abdominal aortic aneurysms (AAAs). Methods: Data were collected prospectively on 221 patients undergoing AAA E VR over a 4-year period (median 5-month follow-up). Patients were classifie d preoperatively as high risk with at least 1 of these features: serum crea tinine > 150 mu mol/L, ischemic heart disease or poor left ventricular func tion, respiratory function < 50% of predicted normal, ruptured or symptomat ic AAA, contraindication to or failed open repair, and age > 80 years. Results: One hundred forty (63.3%) patients were classified as high risk, t he most common criterion being cardiac disease (n = 96, 68.6%). There were 25 (11.3%) deaths in the 30-day perioperative period, 22 (15.7%) in the hig h-risk group compared to 3 (3.7%) in the acceptable-risk group (p = 0.02). The most common causes of perioperative death were multisystem organ failur e and myocardial infarction. A further 21 (9.5%) late deaths occurred, 16 ( 11.4%) in the high-risk group and 5 (6.2%) in the acceptable-risk group (p > 0.1). Conclusions: The mortality of patients at acceptable risk undergoing EVR co mpares with the best published series for conventional open AAA repair. The perioperative and late mortality in the high-risk patients are substantial ly higher.