| dc.description.abstract | Background: Open surgery is a well-established treatment for infrarenal abdominal aortic aneurysm (AAA). In Norway, there has been a reduction in the number of treatments for intact AAA (IAAA), and ruptured abdominal aortic aneurysm (RAAA) using open surgery. The following survey analyzes and discusses the results of treatment for AAA. This study was conducted in Akershus University Hospital (Ahus) during two different time periods, before and after the introduction of endovascular aneurysm repair (EVAR). EVAR was introduced in December 2008 at Ahus. It has been postulated whether the mortality among patients treated with traditional open surgery is higher after EVAR was introduced. This might be due to EVAR being the preferred treatment in so called easy AAA requiring long, straight necks (10 to 15 mm length) and not too angulated, whereas open surgery is used for the remaining difficult cases (angulated and short/no necks). Design: Retrospective analysis Setting: Department of vascular and thoracic surgery, Ahus. Material and methods: Clinical data from the records of 488 patients who were operated with open surgery for AAA was collected from 1995 – 1999 (period I) and 2004 – 2011 (period II). Data in period I was collected prospectively and retrospectively in period II. Information was registered in a standardized form for each patient and entered anonymously in digital form into a database. Different analyses were performed to retrieve the wanted information for this study. Main results: In our study it has been observed that there is low, yet unchanged 30-day mortality among patients treated electively for AAA (2,7 %). Patients treated for RAAA in the last time period had no decline, but still a remaining high 30-day mortality rate (48,1%). There is approximately the same number of patients operated on with open surgery for AAA per year throughout the analyzed time periods. An increasing proportion of women operated for AAA were observed. The mean age at time of operation was 70 years for men, independent of the indications for open surgery. There was a decline in the proportion of smokers operated on for AAA during the time periods. There has also been a decrease in the postoperative length of stay at the hospital in the elective- and rupture group. Moreover, analysis of the data indicated that the use of traditional tube graft is increasing while the use of Y-graft is decreasing, with a concomitant reduction in operation time for the various grafts. Discussion: Still after the introduction of EVAR at Ahus the 30-day mortality rate for electively treated AAA was low and high for RAAA. These findings in this AAA-study correspond well with the results published internationally. The frequent use of traditional tube graft and the decline in use of Y-graft is most likely due to the increasing use of stent graft. This is in accordance with data from the National Vascular Registry (NORKAR). Conclusion: This AAA-study found an unchanged 30-day mortality rate among patients treated with open surgery for infrarenal aneurysms elective or urgent, after the introduction of EVAR at Ahus. | eng |