Treatment of intact abdominal aortic aneurysms (AAA) 2020/2021. Registry report of the German Institute of Vascular Healthcare Research (DIGG) of the German Society for Vascular Surgery and Vascular Medicine (DGG)

Objective: The data for the years 2020 and 2021 from the register of the German Institute of Vascular Healthcare Research (DIGG) of the German Society for Vascular Surgery and Vascular Medicine for the treatment of intact abdominal aortic aneurysms (iAAA) are presented. Method: A total of 148 vascular surgery departments participated in the registry in 2020 and 156 in 2021. The data from3023 patients for the year 2020 and 3312 patients for the year 2021 were evaluated. Results: Of a total of 6335 patients, 4990 (78.8%) underwent endovascular (EVAR) and 1345 (21.2%) open (OR) repair. With EVAR, a total of 56 patients (1.0%) died prior to discharge and with OR 66 patients (4.9%) died. In 86.3% of endovascular interventions for iAAA no complications occurred, in OR there were 903/1345 (67.1%) uncomplicated procedures. Women had an in-hospital mortality of 2.5% (16/647) and men of 0.9% (40/4343) with EVAR (p = 0.002). In OR the in-hospital mortality rate was 5.2%(12/232) for women and 4.9% (54/1113) for men (p = 0.735). Especially patients over 80 years of age benefited fromthe endovascular procedure, the in-hospital mortality was only 1.8% (22/1247) with EVAR but 8.9% (11/123) with OR (p < 0.001). Of a total of 6333 iAAA, 5531 were infrarenal (87.3%) and 802 (12.7%) juxtarenal iAAAs. In EVAR, the in-hospital mortality for treatment of juxtarenal AAA was significantly higher at 14/422 (3.3%) than for treatment of infrarenal AAA at 42/4566 (0.9%, p < 0.001). The in-hospital mortality with open treatment of juxtarenal AAA was 31/380 (8.2%) and was thus significantly higher (p = 0.002) than with open treatment of infrarenal AAA with 35/965 (3.6%). Conclusion: The results from the years 2020 and 2021 on in-hospital mortality and morbidity with endovascular and open repair of the iAAA largely confirmthe published results for the years 2013-2019. In-hospital mortality was lower for EVAR than for OR when treating both juxtarenal and infrarenal iAAAs.