Zur Behandlung des abdominellen aortenaneurysmas in Deutschland. Qualitätssicherungsdaten 2013

Objective. The data for the year 2013 of the registry of abdominal aortic aneurysms (AAA) of the German Society for Vascular Surgery and Vascular Medicine are presented and the results are compared with those of other registries. Methods. In 2013 a total of 76 centers participated in the registry. For ruptured aneurysms (rAAA), 49 centers entered data for open repair (OR) and 32 centers for endovascular repair (EVAR). In total 2257 patients were included, 2041 patients (90.4%) had an intact aneurysm (iAAA), 216 patients (9.6%) a rAAA, 1924 patients (85.2%) were male and 333 (14.8%) were female. Men had an average age of 73 years, 2 years younger than women (average age 75 years) and 21.4% of patients were older than 80 years. The aneurysm diameter in computed tomography (CT) measured in median 55 mm and mean 66.8±75.9 mm. Results. Of the patients with iAAA 73% were treated by EVAR and 27% by OR, 0.9% of patients with iAAA died after EVAR compared to 5.3% after OR. The complication rate after EVAR was about half (12.4%) of that after OR (27.9%) and the intensive care unit (ICU) and hospital stays were shorter. Overall post-interventional hospital mortality (OR and EVAR combined) was 2.1% for iAAA. Of the patients with rAAA 34.7% underwent EVAR and 65.3% OR. Patients with rAAA and EVAR were older (median 79 years) compared with 75 years for OR. No complications occurred in 42.7% of cases with EVAR for rAAA and 23 patients (30.7%) died. Of the rAAA patients treated with OR 18.4% showed no complications and 69 patients (48.9%) died. The combined hospital mortality for rAAA was 42.6% in the register and rAAA showed on average a diameter greater by at least 2 cm than for iAAA. Conclusion. It must be emphasized that these results do not reflect the entire quality of care in Germany for AAA. The main task for the future is, therefore, to include in this registry more centers than in the past in order to make population-based statements in the long run.