Improved long-term survival following infrarenal abdominal aortic aneurysm repair.

Background: The aim was to investigate early and long-term results following AAA repair during a 20-year period.

Method: One thousand and forty one patients with AAA were treated with open surgery (905) or EVAR (136) during the period 1983-2002. Comorbidity and factors influencing early and long-term results were investigated. Data were collected retrospectively from the patients' medical records. A complete follow-up was obtained.

Results: Women had a significantly higher 30-day mortality following repair of ruptured AAA than men. The degree of emergency, advancing age and renal failure were significantly associated with 30-day mortality. We observed an improvement in long-term survival during the study period. Time interval of surgery, cerebrovascular disease, diabetes, COPD and renal failure influenced long-term survival negatively.

Conclusion: Women with ruptured AAA have a higher early mortality than men, which needs to be investigated further. Long-term survival has improved during the study period. Age, diabetes, chronic obstructive pulmonary disease, renal failure and cerebrovascular insufficiency influenced the long-term survival negatively. EVAR is used to an increasing extent and the results are improving.