Long-Term Outcomes of Abdominal Aortic Aneurysm Repair

Introduced in 1991, endovascular approaches for abdominal aortic aneurysm (AAA) surgery now account for more than 40% of elective repairs. Randomized trials have indicated that the endovascular method is associated with lower perioperative mortality and fewer complications than open surgical repair, but long-term outcomes have not been thoroughly assessed. To address this issue, investigators used administrative claims data to evaluate elective AAA repair among Medicare beneficiaries during the period 2001 to 2004. They used propensity scores derived from predictors of the endovascular approach to create matched cohorts of 22,830 patients each.

Perioperative mortality was higher with the open approach than with the endovascular approach (4.8…