Key result
EVAR matches open repair for long-term survival but carries higher reintervention rates.
Why the study?
Long-term outcomes comparing endovascular and open repair of abdominal aortic aneurysm in eligible patients were not fully established.
Does endovascular repair improve long-term survival or reduce reintervention compared to open repair in patients with abdominal aortic aneurysm?
Comparison
Endovascular repair vs open repair
Design
Multicenter randomized clinical trial with 1:1 computer-randomization stratified by center
Follow-up
Mean 6.4 years
Authors
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Similar long-term survival after open or endovascular AAA repair; confirms excess reinterventions with EVAR and reinforces lifelong surveillance.
RCT (n=351)
1:1 ratio via computer algorithm, stratified according to center in a permuted-block sequence of four patients
Yes
Does endovascular repair improve long-term survival or reduce reintervention compared to open repair in patients with abdominal aortic aneurysm?
Absolute Event Rate: 68.9% vs 69.9%
p-value: p=0.97
Endovascular and open repair for AAA have similar long-term survival at 6 years, but endovascular repair is associated with a higher rate of reinterventions.
Philip G. Joseph (2010) conducted an RCT in Abdominal aortic aneurysm (AAA) (n=351). Endovascular repair vs. Open repair was evaluated on Overall survival (95% CI -8.8 to 10.8, p=0.97). Endovascular repair of abdominal aortic aneurysm had similar long-term survival to open repair (68.9% vs 69.9%, p=0.97) but lower freedom from reintervention (70.4% vs 81.9%, p=0.03).
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