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EVAS system linked to higher 3-year survival than traditional EVAR
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An endovascular aneurysm sealing system was associated with higher 3-year survival than traditional endovascular aneurysm repair in patients with abdominal aortic aneurysms, according to findings presented at the Charing Cross International Symposium.
The researchers conducted a retrospective, propensity-weighted study of 333 patients with AAA treated in the U.S. investigational device exemption trial for the endovascular aneurysm sealing (EVAS; Nellix, Endologix) system and 15,431 patients from the Vascular Quality Initiative database who underwent traditional EVAR between 2014 and 2016.
Propensity matching was calculated based on AAA and CV risk factors.
The primary outcome was overall survival at 3 years in the propensity-weighted cohort. The key secondary outcome was overall survival stratified by aneurysm size.
In the propensity-weighted cohort, patients who had AAA repair with EVAS had a 93% rate of survival at 3 years compared with 88% for those who underwent traditional EVAR (HR = 0.59; 95% CI, 0.38-0.92), Marc L. Schermerhorn, MD, chief of the division of vascular and endovascular surgery at Beth Israel Deaconess Medical Center and professor of surgery at Harvard Medical School, said during a presentation.
In patients with aneurysms less than 5.5 cm, there was no significant difference in 3-year survival (EVAS, 94%; EVAR, 91%), but in patients with aneurysms greater than 5.5 cm, survival at 3 years was lower in the EVAR group vs. the EVAS group (92% vs. 86%; HR = 2.01; P = .01), Schermerhorn said.
“Traditional EVAR excludes the aneurysm sac and has been associated with thrombus generation, sac remodeling, inflammation and endoleaks, while EVAS excludes and seals the entire aneurysm sac,” Schermerhorn said in a press release. “The survival difference seen in this study supports the continued development of EVAS therapy and demonstrates its potential to improve patient outcomes. The results also justify further study to compare cardiovascular events between the two therapies in order to understand the mechanism behind the events.”
The EVAS system has not yet been approved for use in the United States. – by Erik Swain
Reference:
Schermerhorn M, et al. Late-breaking aortic trials. Presented at: Charing Cross International Symposium; April 24-27, 2018; London.
Disclosure: The study was funded by Endologix. Schermerhorn reports he received honoraria and travel support from Endologix.