Patients who received the less-invasive endovascular repair of an abdominal aortic aneurysm had a lower risk of death in the first 30 days after the procedure compared to patients who an open repair, but both procedures had similar rates of death after two years, according to a study in the October 14 issue of JAMA, a theme issue on surgical care.
Frank A. Lederle, M.D., of the Veterans Affairs Medical Center, Minneapolis, presented the findings of the study at a JAMA media briefing in Chicago.
"Each year in the United States, 45,000 patients with unruptured abdominal aortic aneurysm (AAA) undergo elective repair, resulting in more than 1,400 perioperative [the first 30 days after surgery or inpatient status] deaths," according to background information in the article. Endovascular repair, performed through a catheter inserted into an artery, was developed to provide a less invasive method than the standard open procedure, which involves an abdominal incision. But "limited data are available to assess whether endovascular repair of AAA improves short-term outcomes compared with traditional open repair," the authors write.
Dr. Lederle and colleagues are conducting a multicenter clinical trial to examine outcomes after elective endovascular and open repair of AAA. This is an ongoing 9-year trial, with this interim report including postoperative outcomes of up to 2 years for 881 patients (age 49 years or older). Patients were randomized to either endovascular (n = 444) or open (n = 437) repair of AAA. Average follow-up was 1.8 years.