Less invasive procedure for repair of abdominal aortic aneurysm may reduce short-term risk of death

Oct 13, 2009

Patients who received the less-invasive endovascular repair of an abdominal aortic aneurysm had a lower risk of death in the first 30 days after the procedure compared to patients who an open repair, but both procedures had similar rates of death after two years, according to a study in the October 14 issue of JAMA, a theme issue on surgical care.

Frank A. Lederle, M.D., of the Veterans Affairs Medical Center, Minneapolis, presented the findings of the study at a JAMA media briefing in Chicago.

"Each year in the United States, 45,000 patients with unruptured abdominal (AAA) undergo elective repair, resulting in more than 1,400 perioperative [the first 30 days after surgery or inpatient status] deaths," according to background information in the article. Endovascular repair, performed through a inserted into an artery, was developed to provide a less invasive method than the standard open procedure, which involves an abdominal incision. But "limited data are available to assess whether endovascular repair of AAA improves short-term outcomes compared with traditional open repair," the authors write.

Dr. Lederle and colleagues are conducting a multicenter clinical trial to examine outcomes after elective endovascular and open repair of AAA. This is an ongoing 9-year trial, with this interim report including postoperative outcomes of up to 2 years for 881 patients (age 49 years or older). Patients were randomized to either endovascular (n = 444) or open (n = 437) repair of AAA. Average follow-up was 1.8 years.

The researchers found that the rate of death after surgery was significantly higher for open repair at 30 days (0.2 percent vs. 2.3 percent), and at 30 days or during hospitalization (0.5 percent vs. 3.0 percent). But there was no significant difference in all-cause death at two years (7.0 percent vs. 9.8 percent), and death after the perioperative period was similar in the two groups (6.1 percent vs. 6.6 percent).

Patients in the endovascular repair group had reduced procedure time, blood loss and duration of mechanical ventilation. " and ICU stays were shorter with endovascular repair and need for transfusion was decreased. No significant differences were observed in major morbidities, secondary procedures, or aneurysm-related hospitalizations," the authors write.

"Longer-term data are needed to fully assess the relative merits of the 2 procedures."

More information: JAMA. 2009;302[14]:1535-1542.

Source: JAMA and Archives Journals (news : web)

Explore further: Liver transplant recipient marks 25th anniversary

add to favorites email to friend print save as pdf

Related Stories

Stent grafts: a better way to treat blunt trauma injuries

Aug 05, 2008

Endovascular repair—fixing an injury in a blood vessel from inside that vessel—is a better option for individuals who receive highly lethal injuries from high-speed collisions or falls (together referred to as blunt ...

Recommended for you

Ebola scare boosts business for US company

10 hours ago

The Ebola scare has subsided in the United States, at least temporarily, but an Alabama manufacturer is still trying to catch up with a glut of orders for gear to protect against the disease.

Thai parliament votes to ban commercial surrogacy (Update)

18 hours ago

Thailand's parliament has voted to ban commercial surrogacy after outrage erupted over the unregulated industry following a series scandals including the case of an Australian couple accused of abandoning a baby with Down's ...

Doctor behind 'free radical' aging theory dies

Nov 25, 2014

Dr. Denham Harman, a renowned scientist who developed the most widely accepted theory on aging that's now used to study cancer, Alzheimer's disease and other illnesses, has died in Nebraska at age 98.

Mexican boy who had massive tumor recovering

Nov 25, 2014

An 11-year-old Mexican boy who had pieces of a massive tumor removed and who drew international attention after U.S. officials helped him get treatment in the southwestern U.S. state of New Mexico is still recovering after ...

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.