Durability of benefits of endovascular versus conventional abdominal aortic aneurysm repair

Abstract

Although initial LOS was shorter for the patients who underwent endovascular as compared with conventional AAA repair, this advantage was lost during the follow-up interval because of frequent readmission for the treatment of procedure-related complications, chiefly endoleak. These readmissions frequently involved the performance of additional invasive procedures. Gender differences existed regarding LOS and the likelihood of complications after open and endovascular AAA repair.

ACC/AHA 2005 Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic): Executive Summary A Collaborative Report From the American Association for Vascular Surgery/Society for Vascular Surgery,⁎⁎AAVS/SVS when Guideline initiated, now merged into SVSSociety for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guideline

“…According to data reported by Anderson (402)(403)(404). Nevertheless, these and other studies (405)(406)(407) also have suggested that the total costs of endovascular repair probably exceed those for open repair, especially when the expense of subsequent follow-up imaging, further intervention, and secondary hospital admissions is added to the base cost ($6000 to $12 000 U.S. dollars) of most endografts. Despite the shorter length of stay and earlier return to normal activity associated with aortic endografting, this procedure does not appear to be associated with superior late functional outcome or longer qualityadjusted life expectancy compared with open surgical treatment (408,409).…”

Reporting mid- and long-term results of endovascular grafting for abdominal aortic aneurysms using the aortomonoiliac configuration

“…4,9,[42][43][44][45][46][47][48][49][50][51] In any case, the technique incorporates an extra-anatomic bypass and should be reserved for unfavorable anatomies and patients unfit for open repair. …”

“…Midterm results of EVAR are sufficiently encouraging to justify the choice of the procedure [1][2][3][4][5][6][7][8] ; however, the long-term verdict is still unclear. [9][10][11][12][13][14][15] Endografting with a bifurcated endoprosthesis is contraindicated in certain patients due to various anatomic restrictions.…”

Clinical Practice Guidelines for Endovascular Abdominal Aortic Aneurysm Repair: Written by the Standards of Practice Committee for the Society of Interventional Radiology and Endorsed by the Cardiovascular and Interventional Radiological Society of Europe and the Canadian Interventional Radiology Association

“…Persistent endoleak, device migration, and limb thrombosis were common causes for these procedures, approximately 25% of which were open surgical and 75% were endovascular procedures (205). The most common indication for secondary intervention is type II endoleak.…”