EVAR versus cirurgia aberta no tratamento do aneurisma de aorta abdominal: revisão de literatura dos últimos 10 anos

• DOI: https://doi.org/10.22533/at.ed.6422501104

• Palavras-chave: aneurisma de aorta abdominal; EVAR; cirurgia aberta; revisão de literatura; mortalidade; complicações.

• Keywords: abdominal aortic aneurysm; EVAR; open repair; literature review; mortality; complications.

• Abstract: Introduction: Abdominal aortic aneurysm (AAA) is a prevalent condition with a high risk of rupture and mortality. Surgical treatment can be performed via endovascular repair (EVAR) or open surgical repair (OSR), making it essential to compare clinical outcomes, durability, and complications. Objective: To review the literature from the last 10 years on EVAR versus OSR for elective AAA repair, emphasizing early and late mortality, complications, need for reinterventions, quality of life, and cost-effectiveness. Methods: A literature review was conducted using PubMed, Scopus, and Web of Science, including clinical trials, cohort studies, and meta-analyses published between 2015 and 2025. Studies directly comparing EVAR and OSR with clear clinical outcomes were included. Data synthesis was performed narratively, complemented by comparative tables. Results: EVAR showed lower perioperative mortality, reduced immediate morbidity, and faster recovery. Long-term follow-up indicated similar mortality between EVAR and OSR, with OSR demonstrating lower reintervention rates and greater repair durability. Individualized technique selection was essential, considering age, comorbidities, aneurysm anatomy, and surgical risk. Conclusion: Both EVAR and OSR are effective, but with distinct profiles. EVAR is advantageous for high-risk and elderly patients due to lower initial morbidity, whereas OSR offers greater long-term durability and fewer reinterventions. Treatment choice should be individualized, balancing safety, durability, and quality of life impact.