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.
“We are playing the same sport, but a different game,” the wise, thoughtful emergency medicine attending physician once told me. “I am playing speed chess – I need to make a move quickly, or I lose – no matter what. My moves have to be right, but they don’t always necessarily need to be the […]
With great successes in hosting our first couple of Twitter chats over the last six months, we’re excited to bring you the third in our quarterly series, #JHMChat, where you ask Journal of Hospital Medicine (JHM) authors about their research and corresponding clinical implications for managing inpatient care. We invite you to join us for […]
Kurt Pfeifer, MD, FACP, FHM Does the phrase “medical clearance” make your skin crawl? Perioperative medicine continues to be a growing part of the practice of hospitalists everywhere, yet for many this is an area they feel uncomfortable with. Never fear! Hospital Medicine 2016 has more perioperative medicine educational offerings than ever! On Sunday, March […]