Best Surgery Options for Aneurysms?

Abdominal aortic aneurysm endovascular and open repair have same health outcomes

/ Author:  / Reviewed by: Chris Galloway, M.D.

(RxWiki News) Most abdominal aortic aneurysms do not have any symptoms and are typically discovered by accident. Treatment requires surgery. In the last ten years, a less invasive surgery has gained popularity.

A recent study found that patients with abdominal aortic aneurysms had similar results whether they had an open or endovascular repair. 

Aneurysms are an enlargement, or ballooning, of the aorta. Open repair requires direct access to the aorta by opening the abdomen with surgery. Endovascular repair is less invasive because doctors make tiny incisions to reach it.

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Dr. Frank Lederle, of the Veterans Affairs Medical Center, and colleagues led the study to examine the long term outcomes of patients receiving open versus endovascular repair.

Study participants were selected from different Veterans Affairs clinics. They were also 49 years or older when the study started.

Researchers randomly assigned 881 patients with abdominal aortic aneurysms to either receive an open or endovascular repair procedure. They followed the patients for nine years.

Overall, there was no long-term differences between the two procedures. Both groups had 146 deaths during the nine years, which is 33 percent.

Within 30 days after the surgery, there were 12 deaths in the endovascular group and 29 in the open repair group. While there were fewer deaths in the endovascular group, this significant difference leveled out at two years.

Even with the improved survival rate, a rupture after the repair continued to be a concern. There were 6 ruptures in the endovascular group, but none in the open repair group. Most deaths after the initial thirty days were the result of cancer or cardiovascular disease. This was true for both groups.

This study was published in the New England Journal of Medicine. It was funded by the Department of Veterans Affairs Office of Research and Development. Dr. Frank Lederle and colleagues disclosed no conflict of interest in the report.

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Review Date: 
December 31, 2012
Last Updated:
January 3, 2013