Key result
Endovascular repair of abdominal aortic aneurysm significantly reduced 30-day mortality compared to open repair (OR 0.19; 95% CI 0.17-0.20; P<0.001).
Why the study?
Does endovascular repair (EVAR) reduce 30-day mortality and myocardial infarction compared to open aneurysm repair (OAR) in patients with elective or ruptured abdominal aortic aneurysm?
Meta-Analysis (n=37,781)
Yes
Does endovascular repair (EVAR) reduce 30-day mortality and myocardial infarction compared to open aneurysm repair (OAR) in patients with elective or ruptured abdominal aortic aneurysm?
Odds Ratio: 0.19 (95% CI 0.17–0.2)
p-value: p=< 0.001
EVAR is associated with significantly lower 30-day mortality, 30-day MI, and hospital length of stay compared to open repair for both elective and ruptured abdominal aortic aneurysms.
Supports EVAR preference to lower early mortality in AAA; confirms meta-analytic benefit for elective and ruptured cases.
Background. We evaluated the incidence of mortality and myocardial infarction (MI) in endovascular repair (EVAR) as compared to open aneurysm repair (OAR) in both elective and ruptured abdominal aortic aneurysm (AAA ) setting. Methods. We analyzed the rates of 30-day mortality, 30-day MI, and hospital length of stay (LOS) based on comparative observation and randomized control trials involving EVAR and OAR. Results. 41 trials compared EVAR to OAR with a total pooled population of 37,781 patients. Analysis of elective and ruptured AAA repair favored EVAR with respect to 30-day mortality with a pooled odds ratio of 0.19 (95% CI 0.17-0.20; I (2) = 88.9%; P < 0.001). There were a total of 1,835 30-day MI events reported in the EVAR group as compared to 2,483 events in the OAR group. The pooled odds ratio for elective AAA was 0.74 (95% CI 0.58-0.96; P = 0.02) in favor of EVAR. The average LOS was reduced by 296.75 hrs (95% CI 156.68-436.82 hrs; P < 0.001) in the EVAR population. Conclusions. EVAR has lower rates of 30-day mortality, 30-day MI, and LOS in both elective and ruptured AAA repair.
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Thomas et al. (2014) conducted a meta-analysis in Abdominal Aortic Aneurysm (elective and ruptured) (n=37,781). Endovascular repair (EVAR) vs. Open aneurysm repair (OAR) was evaluated on 30-day mortality (OR 0.19, 95% CI 0.17-0.20, p=< 0.001). Endovascular repair of abdominal aortic aneurysm significantly reduced 30-day mortality compared to open repair (OR 0.19; 95% CI 0.17-0.20; P<0.001).
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