Endovascular AAA repair cuts short-term risk

Patients who received endovascular repair of an abdominal aortic aneurysm (AAA) had a lower risk of death in the first 30 days after the procedure compared to patients who underwent an open repair, but both procedures had similar rates of death after two years.

The findings are to be published in the October 14 issue of the Journal of the American Medical Association (2009, Vol. 302:14, pp. 1535-1542). Dr. Frank Lederle of the Veterans Affairs Medical Center in Minneapolis presented the study findings at a JAMA media briefing in Chicago.

Lederle and colleagues are conducting a multicenter trial to examine outcomes after elective endovascular and open repair of abdominal aortic aneurysm. The ongoing, nine-year trial includes postoperative outcomes of up to two years for 881 patients (ages 49 years and older). Patients were randomized to either endovascular (444 patients) or open (437 patients) repair of AAA. Average follow-up was 1.8 years.

The researchers found that the rate of death after surgery was significantly lower for AAA versus open repair at 30 days (0.2% versus 2.3%), and at 30 days or during hospitalization (0.5% versus 3.0%). However, there was no significant difference in all-cause death at two years (7.0% versus 9.8%), and death after the perioperative period was similar in the two groups (6.1% versus 6.6%).

The study also found that patients in the endovascular repair group had reduced procedure time, blood loss, and duration of mechanical ventilation.

Related Reading

Boom in endovascular AAA repair is appropriate, study suggests, July 6, 2009

Screening men for abdominal aortic aneurysm saves lives, but is it cost-effective? June 26, 2009

VC/AAA screening combo cost-effective in older adults, March 26, 2009

Study: Endovascular repair can come first for AAA, March 12, 2009

Which modality for AAA? Depends on what you seek, says ISET speaker, February 5, 2008

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