In patients with low to intermediate risk factors, open repair of abdominal aortic aneurysm is as safe as endovascular repair (EVAR) and remains a more durable option.
This is the conclusion of a study with the title “A randomized controlled trial of endovascular aneurysm repair versus open surgery for abdominal aortic aneurysms in low- to moderate-risk patients” published in the “Journal of Vascular Surgery”, May 2011.
This was a randomized controlled trial. It included a total of 300 patients with >5cm aneurysms who were randomized in institutions with proven expertise for both treatments in France. Half of the patients were assigned to each procedure. With a median follow-up of 3 years, there was no difference in the rates of deaths, survival free of major events or number of minor complications between the two groups of patients.
However, in the EVAR group, the crude percentage of re-interventions was higher (16% vs 2.4%) and there was a trend towards higher aneurysm-related mortality (4% vs 0.7%).
It is confirmed, therefore, with this serious study, that, although EVAR may be a good option for some patients, in other cases open repair may be preferable. Most notably in low risk patients, the role of EVAR remains debatable.
