[Open versus percutaneous repair of abdominal aortic aneurysm]

The mortality in aortic abdominal aneurysm surgery remains in the 2-7% range. The aim of the study was to compare the results and safety of surgical aneurysm resection with grafting under general anaesthesia, using percutaneous insertion of a stent under local anaesthesia and intravenous analgesic sedation.

The data from patients scheduled for elective subrenal abdominal aortic treatment was analysed retrospectively. Patients were allocated to two groups, according to their general condition, ASA status, presence of other pathologies and anatomical conditions. Patients in group I underwent open surgery with general anaesthesia; patients in group II received stents implanted using local anaesthesia and intravenous analgesic sedation.

One houndred twenty-seven patients were allocated either to group I (n=87) or to group II (n=40). Blood pressure, heart rate, the need for catecholamines, blood loss and fluid replacement were all higher in group I. More than 50% of patients from this group required mechanical ventilation in the early postoperative period, as well as longer hospitalization. All patients in group II survived, while 6 patients from group I died from postoperative complications.

Endovascular repair of aortic abdominal aneurysms under local anaesthesia combined with i.v. sedation is a safe alternative in high-risk patients.