Outcomes of Endovascular vs. Surgical Repair of Abdominal Aortic Aneurysm

For many patients, an increased risk for late complications and higher costs may be a price worth paying to avoid surgery.

In a new report, investigators for EVAR 1, a randomized multicenter trial, provide the first assessment of both acute and long-term outcomes of endovascular versus open surgical repair of abdominal aortic aneurysm (AAA). Of 1252 participants (mean age, 74 years), 91% were men. Aneurysms were at least 5.5 centimeters in diameter (mean diameter at baseline, 6.4 cm).

Thirty-day mortality was significantly lower in the endovascular-repair group (1.8%) than in the surgical-repair group (4.3%; odds ratio, 0.39). However, at a median follow-up of 6 years, neither overall nor aneurysm-related mortality differed between the two groups because of an increase in aneurysm-related deaths after 4 years in the endovascular-repair group. The findings were c…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)