Mid-term survival and costs of treatment of patients with descending thoracic aortic aneurysms; Endovascular vs. open repair: a case-control study

Objectives. To evaluate the results of open surgery or endovascular stent graft repair of descending thoracic aortic aneurysm (TAA). Design, materials and methods. This is a retrospective multicenter study of 95 patients undergoing TAA repair (42 stent grafts, 53 open repair). The median age was 67 years. Post-operative complications, mid-term survival and costs were assessed. The results were pooled with data in the literature. Results. After a mean follow up of 26 months (open group) and 15 months (endovascular group) survival was similar for patients treated by either repair method. Post-operative lnicumonia was more in the open group (p < 0.02). The hospital costs of open treatment were 40% more than that of the endovascular procedure. Combining the present results with pooled data from the literature the peri-operative mortality and paraplegia rate was less in the endovascular group (p < 0.05). Conclusions. These retrospective data suggest that endografting of descending thoracic aneurysms' can be performed with less peri-operative morbidity, at lower hospital costs, but with equal mid-term life expectancy, compared with open grafting.