[Treatment of abdominal aortic aneurysm: is there still a place for open repair?]

Due to lower peri-operative mortality, lower risk of complications and shorter duration of hospital stay, endovascular aneurysm repair has become preferential treatment for an infrarenal aortic aneurysm. Three randomised studies that compared endovascular repair with open repair now report follow-up data of an average of six years. The data shows a loss of peri-operative mortality advantage after two to three years. More re-interventions are performed following endovascular treatment. The predominant cause of death is due to cardiovascular events, for which optimal medical therapy is crucial. The initial mortality advantage of endovascular aneurysm repair compared to open repair is lost sooner in elderly and high-risk patients than in those patients who are relatively young and low-risk.