No Long-Term Survival Benefit from Endovascular Repair of AAA Versus Open Repair

By Kelly Young

Edited by Susan Sadoughi, MD, and Richard Saitz, MD, MPH, FACP, FASAM

Endovascular repair of abdominal aortic aneurysm carries lower short-term but higher long-term mortality risks than open repair, according to a Lancet study.

Some 1250 U.K. patients aged 60 and up with intact aortic aneurysms were randomized to undergo endovascular or open repair.

After a mean 13-years’ follow-up, aneurysm-related mortality rates were similar between groups (roughly 1 per 100 person-years), as was all-cause mortality (9 per 100 person-years). Endovascular repair was associated with a mortality reduction in the first 6 months, but by 8 years, rates of aneurysm-related and overall mortality were significantly higher in the endovascular repair group. The authors say this was mainly due to secondary sac rupture among those who received endovascular repair.

The authors conclude that patients who do undergo endovascular repair should have regular monitoring, preferably by ultrasound.