Endovascular Aortic Repair Shows Mortality Benefit

Endovascular versus open treatment for abdominal aortic ruptures linked to 90-day mortality drop

WEDNESDAY, June 18 (HealthDay News) -- The availability of endovascular repair for patients with ruptured abdominal aortic aneurysm led to a reduction in early overall mortality, according to research published in the June issue of the Archives of Surgery.

Andreas Wibmer, M.D., of the Medical University of Vienna in Austria, and colleagues analyzed data from 89 patients treated for ruptured abdominal aortic aneurysm (AAA) between October 1999 and July 2006. In the first half of this period, 42 patients were treated with open graft replacement; in the second half an endovascular repair protocol became available, and 16 patients underwent this procedure and 31 received open repair.

The researchers report that the 90-day overall mortality rate dropped from 54.8 percent in the first period to 27.7 percent in the second. When broken into three age groups, the difference was significant only in those older than 75.5 years, in whom survival was especially improved (75 percent versus 28.6 percent). Those treated with endovascular repair were discharged from intensive care significantly earlier, the report indicates.

"We have demonstrated a significant reduction in postoperative mortality that confirmed the observation that offering the combined approach of endovascular AAA repair and open graft replacement led to an improvement in early survival after rupture of an AAA. We showed a similar effect in the elective management of AAA. By offering both treatment options, it was possible to improve the immediate and midterm overall results by shifting high-risk patients from the open graft replacement to the endovascular AAA repair group, thereby improving the results of open surgery," the authors write.

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