Endovascular Aneurysm Repair Has Surpassed Open Repair as the Primary Treatment Modality for Ruptured Abdominal Aortic Aneurysm in the United States and Is Associated With Improved Mortality
The use of endovascular aneurysm repair (EVAR) has changed the treatment algorithm for patients with ruptured abdominal aortic aneurysms (RAAAs). Whereas the overall incidence of RAAA is declining, the proportion of patients treated with EVAR in contemporary practice in the United States is unknown. Therefore, we described the change in incidence, treatment pattern, and outcomes of RAAA using the National Inpatient Sample database from 2004 to 2015.
The aim was to study outcomes of endovascular aneurysm repair (EVAR) and open surgical repair (OSR) of abdominal aortic aneurysms (AAAs) in four geographically adjacent populations with identical demographics and variable EVAR rates.
A retrospective analysis was conducted of the Vascular Quality Initiative between 2013 and 2018.
Roosendaal et al.1 conducted an up to date meta-analysis of mortality outcomes following ruptured abdominal aortic aneurysm (rAAA) in the over 80s, totalling 7 526 patients. The pooled results of eight studies identified an overall mortality rate of 43% at 30 days (27% endovascular aneurysm repair (EVAR), 52% o pen) with a significant advantage of EVAR over open repair. In addition, four studies totalling 2 550 patients reported one year mortality of 47%, also with a relative risk of 0.65 between EVAR and open.
New England Journal of Medicine,Volume 381, Issue 11, September 2019.
Patients older than 80 years have significantly lower early mortality with endovascular aneurysm repair (EVAR) compared with open repair for abdominal aortic aneurysms (AAAs), but long-term results remain poorly studied. We analyzed the results of both emergent and elective AAA repair in patients aged 80 years or older who had at least 5 years of follow-up.
Endovascular abdominal aortic aneurysm repair (EVAR) has been rigorously compared with open repair for the treatment of abdominal aortic aneurysms in randomized trials and observational studies, but a comparison of individual devices is lacking, and single-device registries and trials are limited by small sample size. Here we report a descriptive analysis of the Effectiveness of Custom Seal with Ovation: Review of the Evidence (ENCORE) database, pooled results of multiple studies evaluating the midterm results of EVAR with the Ovation Abdominal Stent Graft Platform.
Endovascular aneurysm repair (EVAR) has become the preferred approach to abdominal aortic aneurysm (AAA) because of lower early morbidity and mortality than open repair. However, the ability of EVAR to prevent long-term aneurysm-related mortality (ARM) has been questioned in light of recent trial data. We have updated our long-term EVAR experience in a large multicenter registry to further examine this issue.
záros J, Tóth C Abstract The management of the abdominal aortic aneurysm is associated with several risk factors, especially in patients after renal transplantation. Endovascular aneurysm repair (EVAR) can be the proper treatment in feasible cases. The authors present a patient's case who underwent renal transplantation and developed an infrarenal aortic aneurysm some years later. A 50-year-old male patient was operated with EVAR. During the starting period of the procedure bilateral iliac dissection developed, and the endovascular approach was converted into traditional open operation. At the time w...
ConclusionThe endovascular neck stabilization is a useful treatment option that facilitates standard EVAR for AAA in chronic aortic dissection.
This study evaluated the impact of hospital case volume on outcomes after rAAA.