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Open Surgery vs. Endovascular Repair of Abdominal Aortic Aneurysms: A Systematic Review

2024; Volume: 6; Issue: 12 Linguagem: Inglês

10.36557/2674-8169.2024v6n12p1764-1775

2674-8169

José António Pereira, Kuezia da Veiga Gonzales Serra, Nícolas Matheus da Fonseca Tinoco de Souza Araújo, Ana Quézia Gonçalves Pereira, ADRIANE NUNES DINIZ, B. Jacques, C. Oliveira, Juan Pablo Gonçalves de Freitas Lima, Divaldo Sampaio, Daniela Aguiar Souza, Diogo Mariano Hildefonso, E. Silva, Pedro Batista, Francisco Mora Miguel, Gonçalo Almeida, Ially Mariana Brito de Lima, Iandra Sarmento Leite de Abrantes, José Vitor Uliano, Júlio Cézar de Oliveira Freitas, Leyla Gabriela Verner Amaral Brandão, Maria Eduarda Fernandes Sathler, Roberta Sales, Ramon Cabral Rodrigues, Claudilene Araújo da Silva, SM Martins, Vinícius Alexandre Costa Tenório, Vitor Gonçalves Leal, Wolney Barros Leal,

Cardiac, Anesthesia and Surgical Outcomes

Endovascular repair (EVAR) and open surgical repair (OSR) are the primary approaches for treating abdominal aortic aneurysms (AAA). Both techniques present unique risks and benefits across short-, medium-, and long-term outcomes. EVAR, being less invasive, is associated with lower perioperative mortality and morbidity rates but carries an increased risk of secondary rupture and reinterventions. Conversely, OSR, although more invasive, demonstrates lower rates of late complications and reinterventions. This study aims to comprehensively analyze and compare the perioperative complications and long-term survival outcomes of these two interventions. To analyze perioperative complications and long-term survival rates associated with endovascular repair and open surgical repair in the management of abdominal aortic aneurysms. A systematic review was conducted using the Scientific Electronic Library Online (SciELO), National Library of Medicine (PubMed), and MEDLINE databases. Predefined inclusion and exclusion criteria were applied, and relevant articles were identified using the keywords “Endovascular repair,” “Open surgery repair,” “Abdominal aortic aneurysm,” and “Complications,” combined with the Boolean operator “AND.” Comparative analysis of EVAR and OSR reveals that EVAR offers lower perioperative mortality and faster recovery but is associated with a higher risk of long-term complications and reinterventions. On the other hand, OSR, despite its invasive nature and higher short-term mortality, is linked to fewer late complications and reinterventions. Both approaches exhibit similar mortality rates over the long term. Therefore, the choice of treatment should be individualized based on the patient’s clinical profile and preferences. EVAR and OSR are equally effective in managing AAA, with differences primarily in perioperative and long-term outcomes. EVAR minimizes perioperative risks but requires ongoing monitoring for late complications, while OSR, though more invasive, offers greater long-term stability with fewer late reinterventions. The choice between these methods should prioritize patient-specific factors and preferences.