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Endovascular Repair of Abdominal Aortic Aneurysm Reduces 30-Day Mortality Risk CHICAGO -- October 13, 2009 -- Patients who received the less-invasive endovascular repair of an abdominal aortic aneurysm (AAA) had a lower risk of death in the first 30 days after the procedure compared with patients who had an open repair, but both procedures had similar rates of death after 2 years, according to a study in the October 14 issue of JAMA. Frank A. Lederle, MD, Veterans Affairs Medical Center, Minneapolis, Minnesota, presented the findings of the study at a JAMA media briefing in Chicago, Illinois. Endovascular repair 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 wrote. Dr. Lederle and colleagues are conducting a multicentre 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 aged 49 years or older. Patients were randomised to either endovascular (n = 444) or open (n = 437) repair of AAA. Average follow-up time was 1.8 years. The researchers found that the rate of death after surgery was significantly higher for open repair at 30 days (0.2% vs 2.3%), and at 30 days or during hospitalisation (0.5% vs 3.0%). But there was no significant difference in all-cause death at 2 years (7.0% vs 9.8%), and death after the perioperative period was similar in the 2 groups (6.1% vs 6.6%). Patients in the endovascular repair group had reduced procedure time, blood loss, and duration of mechanical ventilation. “Hospital and ICU stays were shorter with endovascular repair and need for transfusion was decreased. No significant differences were observed in major morbidities, secondary procedures, or aneurysm-related hospitalisations,” the authors wrote. “Longer-term data are needed to fully assess the relative merits of the 2 procedures.” SOURCE: JAMA E-mail this page to a friend or colleague! To print, use this version