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 25 June 2018

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News

Conventional vs endovascular repair of abdominal aortic aneurysms

Research in this week's New England Journal of Medicine reports perioperative survival advantage with endovascular repair, as compared with open repair, is not sustained after the first postoperative year.

News image

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Only 2 randomized trials have shown better outcomes with elective endovascular repair of abdominal aortic aneurysms than with conventional open repair in the first month after the procedure.

Dr Blankensteijn and colleagues investigated whether this advantage is sustained beyond the perioperative period.

Cumulative rates of aneurysm-related death were 6% for open repair and 2% for endovascular repair
New England Journal of Medicine

The researchers conducted a multicenter, randomized trial comparing open repair with endovascular repair in 351 patients.

The research team included patients who had a diagnosis of abdominal aortic aneurysm of at least 5 cm in diameter and were suitable for both techniques.

The team calculated survival after randomization with the use of Kaplan–Meier analysis and did comparisons with log-rank test on an intention-to-treat-basis.

At 2 years after randomization, the cumulative survival rates were 90% for open repair and 90% for endovascular repair.

The researchers found that the cumulative rates of aneurysm-related death were 6% for open repair and 2% for endovascular repair.

The team noted that the advantage of endovascular repair over open repair was accounted for by events occurring in the perioperative period.

The research team found no significant difference in subsequent aneurysm-related mortality.

In addition, the team observed that the rate of survival free of moderate or severe complications was also similar in the two groups at 2 years.

Dr Blankensteijn concludes, “The perioperative survival advantage with endovascular repair as compared with open repair is not sustained after the first postoperative year.”

NEJM 2005: 352(23): 2398-2405
10 June 2005

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