Why the study?
Is there a volume-outcome relationship for endovascular aneurysm repair (EVAR) similar to that observed with open aneurysm repair (OAR)?
Is there a volume-outcome relationship for endovascular aneurysm repair (EVAR) similar to that observed with open aneurysm repair (OAR)?
This paper discusses the debate surrounding the volume-outcome relationship in endovascular aneurysm repair (EVAR) compared to historical open repair.
Uncertainty persists on EVAR volume-outcome effects; leaves open whether center experience thresholds should guide practice or trial design.
These data were based on OAR, however, which might be considered to be an increasingly historical procedure. The advent of EVAR has changed the provision of vascular surgery by allowing AAA repair at a lower mortality compared with OAR. For example, the EVAR 1 trial reported a reduction in 30-day mortality from 4.7% after OAR to 1.7% after EVAR [5], and these findings were mirrored in both the Dutch Randomised Endovascular Aneurysm Management (DREAM) trial and USA Open Versus Endovascular Repair (OVER) trial [6,7]. However, there has been debate as to how EVAR is best delivered and as to whether the same v olume–outcome relationships would be observed as with OAR.
No takes yet. Share an insight, caveat, or question.
Karthikesalingam et al. (2010) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: