Background: Abdominal aortic aneurysm (AAA) is a dilation of the aorta due to aortic wall continues to weaken. If left untreated to withstand the forces of the luminal blood pressure resulting in progressive dilatation and rupture with a mortality of 50 – 80%. Objective: This study aimed to assess the efficacy of Endovascular Aortic Repair (EVAR) against Open Surgical Repair (OSR), of infra-renal AAA regarding the type of anesthesia, operative time, blood loss, hospital stay, and complications.
Patient and Methods: From January 2016 to December 2017 in Al-Azhar University Hospital and Military Hospitals in Cairo, we assigned 30 patients with AAA ≥5.5 cm in diameter to undergo either EVAR or OSR; in two equal groups. Patients were followed up for type of anesthesia, operative time, blood loss, hospital stay, morbidity, mortality, and complications.
Results: Regarding comorbidities, 90% were smokers, 83.3% were diabetic, 76.7% had hypertension (HTN), and 66.7% had ischemic heart disease (IHD). Regarding intra-operative complications, the overall complications rate was 23.3%, with 3.3% had arrhythmias, 3.3% had distal emboli, and 16.7% had hemorrhages and received a blood transfusion. There was a non-significant difference as regards gender, marital status, smoking, and Diabetes Mellitus between the 2 groups. A comparative study between the 2 groups revealed a significant increase in age, HTN, and IHD in the EVAR group, compared to the OSR group, with a significant statistical difference.  A comparative study between the 2 groups revealed a significant decrease in AAA size and operative time in the EVAR group, compared to the OSR group, with a significant statistical difference. A comparative study between the 2 groups revealed a non-significant difference as regards intra-operative complications and blood transfusion. A comparative study between the 2 groups revealed a significant decrease in the Intensive Care Unit (ICU) and ward stay in the EVAR group; compared to the OSR group. Conclusion: EVAR compared to conventional surgery has some benefits, such as lower hospital stay, ICU stay, blood loss, rates of hospital mortality, rates of complications, and re-intervention.