Response to 're. outcomes after open repair for ruptured abdominal aortic aneurysms in patients with friendly versus hostile aortoiliac anatomy'

摘要

Drs Krenzien and Fellmer have given an interesting and reasonable explanation for the discrepancies between studies assessing the outcomes of patients with friendly and hostile aortoiliac anatomy. The two studies that reported comparable outcomes harboured a larger group of patients treated with endovascular aneurysm repair (EVAR). Our sensitivity analysis, including patients treated with EVAR, showed a comparable risk of dying in those with friendly and hostile anatomy (adjusted odds ratio 1.090, 95% confidence interval 0.593—2.004), which is somewhat contradictory to the explanation given by Krenzien and Fellmer. Nevertheless, we acknowledge their explanation as a valuable addition to those previously described, such as the method of anatomical classification (prospectively vs. retrospectively) and selection bias by haemodynamic stability.