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Use of Endovascular Aortic Aneurysm Repair Increasing

Study suggests outcomes such as death and complications better than for open repair

FRIDAY, Oct. 2 (HealthDay News) -- The use of endovascular repair (EVAR) has increased over open repair (OAR) for the treatment of abdominal aortic aneurysm (AAA) during this decade in the United States, which is associated with better outcomes, according to a study in the October Journal of Vascular Surgery.

Using data from a national all-payer inpatient care database, Margaret L. Schwarze, M.D., from the University of Wisconsin in Madison, and colleagues compared the use and age-specific outcomes of OAR and EVAR for the treatment of AAA from 2001 to 2006.

Over this period, the researchers found that the use of elective EVAR increased significantly from 11,171 to 21,725, while the use of elective OAR decreased significantly from 17,784 to 8,451. EVAR patients had shorter mean hospital stays (2.99 versus 8.78 days), lower in-hospital mortality (odds ratio, 0.23), fewer in-hospital complications (odds ratio, 0.27), and were more likely to be discharged to home (odds ratio, 3.95). Patients 85 years and older had a significant increase in the total number of asymptomatic AAA repairs compared with younger patients, and the oldest patients had the most dramatic reduction in complications after EVAR.

"As short-term surgical outcomes are consistently improving for patients undergoing AAA repair, elective EVAR has replaced OAR as the more common method of repair in the United States," the authors conclude. "The introduction of this technology has been rapidly adopted, particularly for the oldest-old surgical patients, aged ≥85 years, who previously may not have been offered surgical intervention for asymptomatic AAA."

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