In this multi-center trial of >1200 patients with large (>5.5cm) AAAs, they were randomized to elective repair by open or endovascular techniques. 30 day death was significantly lower in the endovascular group (1.8% vs 4.3%) but there was no difference in all-cause mortality by the end of follow-up between the groups. The endovascular group had higher rates of complications and re-interventions, and higher overall cost (abstract). This study is consistent with the recently published EVAR-1 Trial (link) which found in patients ineligible for open repair, endovascular repair was associated with lower aneurysm-related death, but there was no benefit to all-cause mortality. Type of AAA repair will likely be driven by patient-specific and physician preferences, and life expectancy.
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.