Outcome after open and endovascular repairs of abdominal aortic aneurysms in matched cohorts using propensity score modeling

Abstract

In this retrospective propensity score-matched study, early mortality was similarly low after both EVAR and OR, significantly different from all except one large randomized controlled trial. EVAR had fewer early complications, but it was associated with late all-cause mortality and reinterventions and had a small but definite risk of late rupture. Significantly increased mortality at 5 years was no longer observed when operations were performed after 2005. High risk, advanced age, cancer history, and AAA size predicted late all-cause mortality. This study failed to confirm early or late survival benefit for EVAR vs OR. Improved surveillance, longer follow-up, and analysis of factors affecting late death in prospective studies are warranted.

Abdominal aortic aneurysm repair in octogenarians is associated with higher mortality compared with nonoctogenarians

“…Morbidity after AAA repair was recently estimated to be 24% for OAR and 13% for EVAR in matched cohorts. 25 Similarly, we report a morbidity rate of 30% and 7% among nonoctogenarians undergoing OAR and EVAR, respectively. Morbidity among octogenarians was significantly higher, occurring in 41% for OAR and in 10% for EVAR.…”

External validation of a 5-year survival prediction model after elective abdominal aortic aneurysm repair

“…This is a subset of patients whose outcomes have been previously reported. 4 All patients had infrarenal aortic clamping (thus potentially eligible for either OAR or EVAR), and emergent/urgent cases were excluded. Further detail of this cohort of patients has been previously reported.…”

“…Further detail of this cohort of patients has been previously reported. 4 Patient demographics, comorbidities (defined by Society for Vascular Surgery/American Association for Vascular Surgery [SVS/AAVS] comorbidity scores), 5 and procedural information were recorded. This study was approved by the Mayo Clinic Institutional Review Board and was deemed exempt from the need for patient consent.…”

Ruptured abdominal aortic aneurysm: open vs. endovascular repair: literature review

“…More specifically, participants who are haemodynamically stable are often assigned to EVAR, introducing a well-defined selection bias [42]. While there is an accompanying body of observational research failing to reveal any early-mortality benefit in utilising an endovascular approach [15,31,36,40,[43][44][45], there are virtually no literature items reporting EVAR as a more morbid curative approach [37]. So while there is no high-level evidence from randomised trials supporting EVAR over OR from an early mortality perspective [15,36], the trends within observational research favour the former.…”