Two-Year Outcomes after Conventional or Endovascular Repair of Abdominal Aortic Aneurysms

Background Two 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. We investigated whether this advantage is sustained beyond the perioperative period. Methods We conducted a multicenter, randomized trial comparing open repair with endovascular repair in 351 patients who had received a diagnosis of abdominal aortic aneurysm of at least 5 cm in diameter and who were considered suitable candidates for both techniques. Survival after randomization was calculated with the use of Kaplan–Meier analysis and compared with the use of the log-rank test on an intention-to-treat-basis. Results Two years after randomization, the cumulative survival rates were 89.6 percent for open repair and 89.7 percent for endovascular repair (difference, –0.1 percentage point; 95 percent confidence interval, –6.8 to 6.7 percentage points). The cumulative rates of aneurysm-related death were 5.7 percent...

[1]  J. Alsac,et al.  Short- and long-term outcome following endovascular aneurysm repair. How does it compare to open surgery? , 2004, The Journal of cardiovascular surgery.

[2]  F. Fowkes,et al.  Long-term outcomes of immediate repair compared with surveillance of small abdominal aortic aneurysms. , 2002, The New England journal of medicine.

[3]  北村 聖.  "The New England Journal of Medicine". , 1962, British medical journal.

[4]  P. Desgranges,et al.  Midterm Survival after Endovascular versus Open Repair of Infrarenal Aortic Aneurysms , 2005, Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists.

[5]  F. Lederle.  Abdominal aortic aneurysm--open versus endovascular repair. , 2004, The New England journal of medicine.

[6]  E. Buskens,et al.  The Dutch Randomised Endovascular Aneurysm Management (DREAM) trial. Background, design and methods. , 2002, The Journal of cardiovascular surgery.

[7]  Jeroen J. Bax,et al.  Optimizing long-term cardiac management after major vascular surgery: Role of beta-blocker therapy, clinical characteristics, and dobutamine stress echocardiography to optimize long-term cardiac management after major vascular surgery. , 2003, Archives of internal medicine.

[8]  R. Rutherford,et al.  Recommended standards for reports dealing with lower extremity ischemia: revised version. , 1997, Journal of vascular surgery.

[9]  P. MacEneaney,et al.  Abdominal aortic aneurysms: elective endovascular repair versus conventional surgery--evaluation with evidence-based medicine techniques. , 2003, Radiology.

[10]  A. R. Brady,et al.  Long-term outcomes of immediate repair compared with surveillance of small abdominal aortic aneurysms. , 2002 .

[11]  Pascal Desgranges,et al.  Incidence and risk factors of late rupture, conversion, and death after endovascular repair of infrarenal aortic aneurysms: The EUROSTAR experience , 2000 .

[12]  Gianbattista Parlani,et al.  Clinical effect of abdominal aortic aneurysm endografting: 7-year concurrent comparison with open repair. , 2004, Journal of vascular surgery.

[13]  Erik Buskens,et al.  A randomized trial comparing conventional and endovascular repair of abdominal aortic aneurysms. , 2004, The New England journal of medicine.

[14]  G. Moneta,et al.  Comparison of Endovascular Aneurysm Repair With Open Repair in Patients With Abdominal Aortic Aneurysm (EVAR Trial 1), 30-Day Operative Mortality Results: Randomised Controlled Trial , 2006 .

[15]  E. Antman,et al.  ACC/AHA Guideline Update for Perioperative Cardiovascular Evaluation for Noncardiac Surgery—Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1996 Guidelines on Perioperative Cardiovascular Evaluati , 2002, Journal of the American College of Cardiology.

[16]  Jeroen J. Bax,et al.  Association between long-term statin use and mortality after successful abdominal aortic aneurysm surgery. , 2004, The American journal of medicine.

[17]  C D Holman,et al.  Long term relative survival after surgery for abdominal aortic aneurysm in Western Australia: population based study , 1998, BMJ.

[18]  C. Zarins,et al.  Reporting standards for endovascular aortic aneurysm repair. , 2002, Journal of vascular surgery.