EVAR reduces periprocedural events in younger patients

In patients younger than 70 years, endovascular aneurysm repair decreased risk for 30-day mortality, morbidity and length of hospital stay compared with open aneurysm repair. However, long-term outcomes were similar between groups.

The meta-analysis included studies from the Medline, Central and OpenGray databases searched from 2000 to March 2015. Researchers compared periprocedural outcomes, defined as 30-day morbidity and mortality and length of hospitalization, and long-term outcomes, defined as long-term mortality and rate of secondary procedures, among patients younger than 70 years with abdominal aortic aneurysm (AAA) who underwent endovascular aneurysm repair (EVAR) or open surgical repair.

The final analysis included one randomized controlled trial and eight observational studies, covering 18,089 patients who received open repair and 16,814 patients who received EVAR.

Results indicated reductions in 30-day mortality (OR = 0.25; P < .001) and 30-day morbidity (OR = 0.36; P < .001) and a shorter length of hospitalization (mean difference, –4.28 days; P < .001) in the EVAR group.

However, the long-term survival advantage with EVAR did not reach statistical significance (OR = 0.48; P = .16), and the rate of reintervention was comparable between groups (OR = 0.94; P = .89).

“Emerging evidence supports a beneficial effect of endovascular AAA repair as compared with open surgery in young patients,” the researchers wrote. “In the absence of high-quality evidence, this practice may be applied with caution. It is necessary for future trials and cohort studies to provide separate data on young patients, which would allow for further elucidation of the comparative impact of endovascular and open AAA repair in this subgroup of patients.” – by Brian Ellis

Disclosure: The researchers report no relevant financial disclosures.

Published by:

Sources/Disclosures

Collapse

Source: Kontopodis N, et al. J Endovasc Ther. 2015;doi:10.1177/1526602815606937.