What About Endovascular Repair of Abdominal Aortic Aneurysm in Inoperable Patients?

Although endovascular repair reduced the number of aneurysm-related deaths in the long term, it did not affect overall mortality.

In this companion to the EVAR 1 report (JW Cardiol Apr 14 2010), investigators examined outcomes in patients with abdominal aortic aneurysms (AAAs) ≥5.5 centimeters in diameter (mean diameter at baseline, 6.7 cm) who were considered ineligible for open surgical repair. The investigators randomized 404 patients (mean age, 77; 86% men) to undergo endovascular repair or no repair. Midterm results were published after 4 years of follow-up (JW Cardiol Jul 29 2005); this report presents findings up to 8 years.

Reasons for surgery ineligibility included coexisting cardiac, renal, or pulmonary illness. Nonetheless, 70 of the 207 patients assigned to no repair eventually underwent repair. Thirty-day mortality in the endovascular-repair group was 7.3%…

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)