Comparative evaluation of the results of surgical and endovascular methods of abdominal aortic aneurysm repair in patients with low and medium risk factors

Background. According to the data by various authors the incidence of abdominal aorta aneurysms varies from 8 to 12%, with the mortality rate reaching 7.2-9,0%. At present, two alternative methods of repair exist: surgical and endovascular procedures. Methods. The study involved 98 patients with athero-sclerotic aneurysms of an infrarenal part of the abdominal aorta with unexpressed concomitant pathology (without signs of ischemic heart disease, a light degree of chronic obstructive lung disease, etc.). The first group of 38 patients underwent endovascular repair of abdominal aorta aneurysms. The second group involved 60 patients who underwent open resection of the aneurysm followed by conventional implantation of a linear or bifurcational prosthesis. Results. In the endovascular repair group significantly better intraoperative and early postoperative indicators were observed (absence of marked pain syndrome, shorter hospital stay). However, in the late postoperative period complications were recorded: endoleak n=4 (10.8%), graft thrombosis in the region of iliac arteries n=2 (5.3%), decrease of sexual potency because of the involvement of internal iliac arteries n=3 (7.9%). Some complications required complex repetitive surgical interventions. No complications directly related to aortic repair were observed in those patients who underwent surgical treatment during 5-year follow-up. Conclusions. Endovascular abdominal aortic aneurysm repair is a highly effective and less traumatic method of treatment. However, in patients with low and medium risk factors surgical treatment should be considered as a priority.