Abstract
The authors investigated whether endovascular aneurysm repair (EVAR) to exclude abdominal aortic aneurysm (AAA) in patients considered unfit for open surgical repair improves survival compared with no intervention. The randomized controlled trial included 338 patients aged 60 years or older with an aneurysm of at least 5.5 cm in diameter, of whom 166 wereto receive EVAR and 172 had no intervention. The end points were all-cause mortality, aneurysm-rated mortality, postoperative complications, health-related quality of life, and hospital costs. The 30-day operative mortality in the EVAR group was 9%, and the no intervention group had a rupture rate of 9 per 100 person years. There was no significant difference in aneurysm-related mortality between the groups. Overall mortality after 4 years was 64%. The authors concluded that EVAR had considerable 30-day operative mortality in patients already unfit for open AAA repair. It did not improve survival over no intervention.
Get full access to this article
View all access options for this article.