Comparison between Open and Endovascular Repair for the Treatment of Juxtarenal Abdominal Aortic Aneurysms: A Single-Center Experience with Midterm Results

Background To evaluate the optimal treatment for juxtarenal abdominal aortic aneurysm (JAAA), we compared the outcomes of open surgical repair (OSR) with endovascular aortic repair (EVAR) using a variety of fenestrated and snorkel EVARs. Methods We evaluated overall survival, aneurysm-related death, reintervention, and renal impairment in 152 JAAAs retrospectively, excluding cases of aortic dissection and rupture. Cox models were used to assess survival and assessed postoperative dialysis rates following surgery. Results OSR and EVAR were performed in 81 and 71 patients, respectively. The mean age was significantly higher in the EVAR group (overall, 74.5 years; OSR, 71 years; and EVAR; 77 years). High preoperative serum creatinine levels, cerebrovascular disease, and chronic obstructive pulmonary disease were more prevalent in the EVAR group. Mean operative time, hospital stay, and perioperative blood loss were significantly greater in the OSR group ( P