[Abdominal aortic aneurysms. Results of surgical treatment from 1987 to 1998]

Conventional open surgery for abdominal aortic aneurysm has recently been challenged by a closed transfemoral approach for repair (stent-graft). The presented data over the past eleven years after open surgery for graft implantation are intended to serve for comparison with future results after transfemoral graft placement. In addition, it is the purpose of this study to investigate the prognostic importance of treatment of concomitant coronary artery disease. Early mortality of all 195 consecutive patients with abdominal aortic aneurysm repair was 1.5%; it was 0.6% after elective repair for infrarenal aneurysm and not dependent on the presence of coronary artery disease if the latter was treated. Late outcome, however, related closely to coronary artery disease as a major risk factor. Late graft complications are extremely rare and occurred only once (graft thrombosis). Incisional hernias and impotence in male patients are non-lethal complications affecting quality of life. Open surgical repair of abdominal aneurysm is safe, and long-term, complication-free survival is good. Coronary artery disease is the most frequent concomitant disease and major risk factor requiring close observation and treatment. These results need to be matched by the new transfemoral graft implantation technique before broad application of the latter.