The impact of endovascular treatment on in-hospital mortality following non-ruptured AAA repair over a decade: a population based study of 16,446 patients.

OBJECTIVES: We hypothesised that over the past decade, the nation-wide outcome of infrarenal abdominal aortic aneurysm (AAA) repair has improved with the introduction of endovascular treatment. The aim of the study was to identify endovascularly-treated patients in a national registry and to assess the impact on in-hospital mortality of non-ruptured AAA repair, if any, after the introduction of endovascular repair.
MATERIALS AND METHODS: We retrospectively studied the nation-wide outcome of non-ruptured AAA repair over the past decade. Variables studied were age and gender of the patients, hospital size and type and the year in which treatment was performed and the outcome on in-hospital mortality. The in-hospital mortality of non-ruptured AAA repair in 16,446 patients in the 10-year period from 1991 to 2000 was 7.3% (6.2-8.2%). In the 15,589 (95%) patients that underwent conventional treatment, in-hospital mortality was 7.6% (7.0-8.1%), whereas in the endovascular group it was 1.9% (0.6-3.5%). In the multivariate analysis, age and endovascular repair were the most important independent predictors of in-hospital mortality.
CONCLUSION: With the limitations of a national registry aside, the introduction of endovascular aneurysm repair seems to have had a small but significant impact on in-hospital mortality following infrarenal AAA repair.