Which Repair for Abdominal Aortic Aneurysm?

Endovascular repair of abdominal aortic aneurysms (AAAs) is less invasive than conventional open surgery. Although endovascular graft technology continues to advance, graft durability remains uncertain. In contrast, grafts after open surgery generally last 20 to 30 years.

In a multicenter randomized trial of endovascular versus open repair, researchers in the U.K. assessed short-term mortality in 1082 patients (mean age, 74; 91% men; minimum AAA diameter, 5.5 cm; mean, 6.5 cm) who were eligible to undergo either procedure. Each center determined which of six devices to use; 90% of grafts were bifurcated, and 10% were aorto-uni-iliac.

The median time from randomization to surgery was 43 days in the endovascular group and 35 days in the open-re…