Thirty-five studies on open abdominal aortic aneurysm repair, five studies on endovascular abdominal aortic aneurysm repair, and four studies on both, were included in the review (n=2,966 patients). Study designs were not reported in detail, but the authors stated that almost all were single institutional series and retrospective in nature.
Open abdominal aortic aneurysm repair studies had a median sample size of 31 patients (range 6 to 246), whilst endovascular abdominal aortic aneurysm repair studies had a median sample size of 50 (range 16 to 697). Ninety percent of the open abdominal aortic aneurysm repair studies and 78% of the endovascular abdominal aortic aneurysm repair studies were susceptible to selection bias.
Across the open abdominal aortic aneurysm repair studies (n=1,807 patients), the perioperative mortality rate varied from 0 to 33% and the overall mortality rate was 5.6% (95% CI 4.5 to 6.7). The median five-year survival rate was 60% (range 14 to 86%).
Across the endovascular abdominal aortic aneurysm repair studies (n=1,159 patients), perioperative mortality varied from 0 to 6% and the overall mortality rate was 4.5% (95% CI 3.3 to 5.7). The median five-year survival rate could not be calculated, as only one study provided this length of follow-up.
Perioperative death was not statistically significantly different between endovascular and open abdominal aortic aneurysm repair surgery. The rate of complications was statistically significantly higher after open abdominal aortic aneurysm repair (OR 1.86, 95% CI 1.47 to 2.34).