Does EVAR reduce mortality compared to open surgical repair or no intervention in individuals with abdominal aortic aneurysm?
EVAR offers a short-term mortality benefit over open surgical repair in fit patients with abdominal aortic aneurysms, but this advantage is lost long-term and is associated with higher reintervention rates.
In individuals considered fit for conventional surgery, EVAR was associated with lower short-term mortality than OSR. However, this benefit from EVAR did not persist at the intermediate- and long-term follow ups. Individuals undergoing EVAR had a higher reintervention rate than those undergoing OSR. Most of the reinterventions undertaken following EVAR, however, were catheter-based interventions associated with low mortality. Operative complications, health-related quality of life and sexual dysfunction were generally comparable between EVAR and OSR. However, there was a slightly higher incidence of pulmonary complications in the OSR group than in the EVAR group.In individuals considered unfit for open surgery, the results of a single trial found no overall short- or long-term benefits of EVAR over no intervention with regard to all-cause mortality, but individuals may differ and individual preferences should always be taken into account.
Paravastu et al. (2014) studied this question.