Less Invasive Procedure to Repair AAA
Reported October 15, 2009
(Ivanhoe Newswire) -- 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 had
an open repair; however, both procedures had similar rates of death after
two years, according to a new study.
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.
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," study authors were quoted
Frank A. Lederle, M.D., of the Veterans Affairs Medical Center in
Minneapolis, and colleagues are conducting an ongoing nine-year,
multi-center clinical trial to examine outcomes after elective endovascular
and open repair of AAA. This interim report includes postoperative outcomes
of up to two years for 881 patients. Patients were randomized to either
endovascular or open repair of AAA. Average follow-up was 1.8 years.
The researchers found that the rate of death 30 days after surgery was
significantly higher for open repair, but there was no significant
difference in all-cause death at two years.
Patients in the endovascular repair group had significant reductions in
blood loss and duration of mechanical ventilation.
"Hospital and ICU stays were shorter with endovascular repair and need for
transfusion was decreased," the authors wrote. "No significant differences
were observed in major morbidities, secondary procedures, or
aneurysm-related hospitalizations. Longer-term data are needed to fully
assess the relative merits of the two procedures."
SOURCE: Journal of the American Medical Association (JAMA), October 14, 2009