Professor Alun Davies describes the outcomes of both endovascular repair and open surgery. He explains that the reintervention rate (the risk of having another procedure) for endovascular repair is higher because of complications. Endovascular repair has been outcomes after surgery, but open repair is more favourable a few years down the line. These are important factors to consider with your clinician when deciding which option to go for.
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Going back to talk about the downsides of endovascular aneurysm repair, is that a number of patients will develop an indication for re-intervention. This may be due to an endoleak, which is because various blood vessels haven't been sewn off, or at the time of fixation there isn't a good seal, or there has been a problem with the graft material. The intervention rate is anything between 14-20% in patients who have had an endovascular aneurysm repair. There is a much lower re-intervention rate in patients having traditional open repair. One of the main indications for re-intervention in somebody having an open repair is the fact that the patient may be left with an incisional hernia in the abdominal wall and this may require re-intervention. However, the key things are that the early mortality with endovascular aneurysm impaired at 30 days is three-fold less than it is with open repair. However, once you get to 5, 10 and 15 years, you can see that there is an overall benefit in open repair because you have not had to offer the patient's intervention for these endo leaks. So there is a strong argument that if you have got a fit patient then they should probably be offered open aneurysm repair as opposed to endovascular aneurysm repair.
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