Surgical approach outcomes for AAA differ by iliac bifurcation involvement

A multi-institutional VQI database study of 17,009 patients compared transperitoneal (TPA) and retroperitoneal (RPA) approaches for open aortic repair of abdominal aortic aneurysm, stratified by iliac bifurcation involvement. The study reported that among patients with isolated AAA, TPA was associated with higher 30-day mortality, MACE, and lower 1-year survival compared to RPA, whereas among patients with aneurysms involving the iliac bifurcation, TPA was associated with lower odds of lower extremity ischemia with no significant differences in mortality, MACE, or 1-year survival. The authors state that iliac bifurcation involvement appeared to modify which surgical approach was associated with better outcomes.

Most relevant for: Patients undergoing open aortic repair for abdominal aortic aneurysm, including those with aneurysms extending to the iliac bifurcation.

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