Abdominal aortic aneurysm repair in obese patients: Improved outcome after endovascular treatment compared with open surgery

Purpose: To investigate outcomes in obese patients with abdominal aortic aneurysm (AAA) treated with elective open or endovascular repair (EVAR). Study Design: We compared the outcomes of obese patients with AAA treated with elective open repair and EVAR. Obesity was defined as a body mass index (BMI) ≥30 kg/m². Results: A total of 56 patients with a BMI ≥30 kg/m² were identified for analysis (mean age 70 ± 8 years; mean BMI 34 ± 4 kg/m², and 95% [n = 53] were male). Open surgery was performed in 55% (n = 31). The in-hospital complication rate (including nonsurvivors) was significantly increased after open repair compared with EVAR (26% vs 4%, P =.033). Mortality did not differ significantly during 3 years of follow-up (P =.816). Length of stay, intensive care unit (ICU) stay, and need for ventilation were significantly increased after open surgery compared with EVAR. Conclusions: We observed improved short-term outcomes among obese AAA patients after EVAR compared to open repair. Endovascular repair may be preferable in obese patients with AAA.