Results of conventional surgical therapy for abdominal aortic aneurysms since the beginning of the "endovascular era"

Introduction: In 1990 the new method of endovascular graft treatment of abd ominal aortic aneurysms (AAA) emerged. For this reason we analyzed the resu lts of open surgery for AAA in our department to consider the question of s tandard therapy. Methods: Tn a retrospective study the medical data of 941 consecutive patients treated by open surgery in a single center from 1990 t o 1997 (mean age 67 years, 14.5% female, 3.2% suprarenal AAA) were analyzed . Operations were performed electively in 778 asymptomatic patients, urgent ly in 104 symptomatic patients, and as emergency operations (immediately af ter admission) in 59 symptomatic patients (45 patients presenting with rupt ure). Results: Mortality was 1.54% (elective operations), 8.65% (urgent ope rations), and 35.6% (emergency operations, rupture). Morbidity was 15.9% (e lective operations), 28.8% (urgent operations), and 66.7% (emergency operat ions, rupture). Mortality was not increased in patients undergoing addition al procedures of the renal, iliac, femoral, or crural arteries. Conclusion: Because of its low mortality and morbidity today open surgical repair rema ins the standard therapy for AAA.