Key result
EVAR for small AAAs yields similar overall survival and perioperative mortality versus large AAAs.
Why the study?
Does EVAR for small AAA (≤5 cm) improve outcomes compared to large AAA (>5 cm) in patients with abdominal aortic aneurysms?
Cohort (n=192)
Does EVAR for small AAA (≤5 cm) improve outcomes compared to large AAA (>5 cm) in patients with abdominal aortic aneurysms?
p-value: p=.6066
Under controlled conditions of patient and device selection, EVAR outcomes do not significantly differ between small (≤5 cm) and large (>5 cm) abdominal aortic aneurysms.
No difference in EVAR outcomes by AAA size; leaves open whether size should guide candidacy outside controlled trial settings.
OBJECTIVE: To determine whether there is a difference in outcome between endovascular repair of abdominal aortic aneurysm (EVAR) of small versus large aneurysms. METHODS: A total of 192 patients from the Power-link trial were subdivided into small abdominal aortic aneurysms (AAA; </=5 cm) and large AAA (>5 cm) groups. Demographics, perioperative morbidity, mortality, overall survival, and freedom from major adverse events, endoleak, aneurysm-related death, migration, and secondary procedures were assessed. Aneurysmal involvement of the iliacs as well as neck length and angulation was compared between groups. RESULTS: Perioperative morbidity (P = 1.000), mortality (P = .4603), and extent of iliac involvement did not differ between groups (P = .2260). The necks in small AAA were longer (P = .0028) and less angulated (P < .0001). There was no difference in overall survival (P = .6066), freedom from major adverse events (P = .7842), endoleak, (P = .1832), migration (P = .5765), aneurysm-related death (P = .4728), or need for secondary procedures (P = .2323). CONCLUSION: Under controlled conditions of patient and device selection, there is no significant difference in outcome for EVAR of small versus large AAA.
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Wang et al. (2008) conducted a cohort in Abdominal aortic aneurysm (n=192). Small abdominal aortic aneurysm (≤5 cm) vs. Large abdominal aortic aneurysm (>5 cm) was evaluated on Overall survival (p=.6066). Endovascular repair of small abdominal aortic aneurysms (≤5 cm) resulted in similar overall survival (P=0.6066) and perioperative mortality (P=0.4603) compared to large aneurysms (>5 cm).
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