Key result
EVAR integration for ruptured aneurysms is linked to ~23% lower mortality versus surgery alone.
Why the study?
Does the integration of EVAR as a first option reduce total mortality in patients with ruptured abdominal or iliac aneurysms compared to a surgery-only approach?
Cohort (n=85)
No
Does the integration of EVAR as a first option reduce total mortality in patients with ruptured abdominal or iliac aneurysms compared to a surgery-only approach?
Integrating EVAR as a first-line option for ruptured abdominal and iliac aneurysms may reduce overall mortality compared to a surgery-only approach.
May support EVAR-first approach in selected ruptured aneurysms; leaves open whether selection or therapy drove mortality change.
PURPOSE: To evaluate the influence of endovascular therapy of ruptured abdominal or iliac aneurysms on total mortality. MATERIALS AND METHODS: We analyzed the mortality of 40 patients from 2005 to 2009, when only surgical treatment was available. These results were compared with the period 2010 to 2013, when endovascular aneurysm repair (EVAR) was assessed as the first option in selected patients. RESULTS: During 2005 to 2009, the mortality was 37.5%. From 2010 to 2013, 45 patients were treated with mortality 28.9%. Open repair was performed in 35 (77.8%) patients and EVAR in 10 (22.2%) patients. The 30-day and 1-year mortality rates of the EVAR group were 0% and 20%, respectively, and the total mortality rate was 30% during follow-up (median 11 months, range 1-42 months). The 30-day mortality in the surgical group remained unchanged, at 37.1%, and 1-year and total mortality rates were 45.7% and 51.4%, respectively. CONCLUSION: Following integration in the treatment algorithm, EVAR decreased total mortality in our center by 8.6%.
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Raupach et al. (2014) conducted a cohort in Ruptured abdominal or iliac aneurysms (n=85). Integration of endovascular aneurysm repair (EVAR) vs. Surgical treatment only was evaluated on Total mortality. Integration of endovascular aneurysm repair into the treatment algorithm for ruptured abdominal or iliac aneurysms decreased total mortality by 8.6% (from 37.5% to 28.9%).
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