Abdominal aortic aneurysms part two: Surgical management, postoperative complications and surveillance.
Harry Kyriacou, Ahmed M H A M Mostafa, Anoop S Sumal and 2 others
PMID 32895001WHAT IT FOUND
This review summarises guidelines for abdominal aortic aneurysm repair, noting that endovascular repair has lower early mortality but higher long-term complications than open repair, requiring strict post-operative surveillance.
Key findings
01Endovascular repair has lower early mortality but higher long-term mortality and complication rates compared to open surgical repair.
02Patients with ruptured aneurysms treated with endovascular repair have lower in-hospital mortality than those treated with open repair.
03Post-operative surveillance protocols differ significantly between guidelines, with some recommending routine imaging for all endovascular patients and others advocating case-by-case assessment.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a narrative review of existing guidelines and published studies, not a primary research study, so it does not provide new evidence. The review notes significant discrepancies between major guideline bodies (NICE, ESVS, SVS) regarding surveillance frequency and patient selection for surgery, which may cause confusion in clinical practice. It relies on data from various sources with different follow-up periods and patient populations, making direct comparisons between studies potentially unreliable.
Declared interests
No competing interests declared.
The easy way to misread this
Do not assume that the less invasive endovascular repair is superior for all patients. While it has lower early mortality, it is associated with significantly higher long-term complications, re-intervention rates, and late mortality compared to open repair, necessitating strict long-term surveillance.