Endovascular aneurysm repair (EVAR) is safer than open surgical repair for treating abdominal aortic aneurysms (AAA) and is associated with lower in-hospital mortality rates and length of stay, according to research presented at the Society of Interventional Radiology's (SIR) annual scientific meeting in San Francisco.
In a large retrospective study, a research team from Saint Francis Hospital in Evanston, IL, found that nearly 40% of patients who received open surgery died in the hospital, while only 28% of those who received EVAR died. In addition, the average length of hospital stay was about three days less for patients who received EVAR.
To compare outcomes from EVAR and open surgery, the researchers mined the National Inpatient Sample, an all-payor database that contains information on approximately 8 million hospital encounters per year in the U.S. From 2001 to 2009, 38,859 individuals with an average age of 74 had a ruptured AAA and were treated by either EVAR or open surgery: 32,069 patients received open surgery, while 6,790 had EVAR.
Open surgery was associated with an average length of hospital stay of almost 14 days, while EVAR had an average of approximately 11 days. Thirty-five percent of patients were able to go home without requiring further in-patient rehabilitation after endovascular repair, while only 22% of those who received open surgery were discharged to their homes.
In an interesting finding, women had worse outcomes compared to men after the procedure, regardless of the type of repair. In-hospital mortality for open surgery was 37.5% for men and 47% for women, while in-hospital mortality for EVAR was 27% for men and 32.3% for women. The gender differences were statistically significant (p < 0.001).
Co-author Dr. Prasoon Mohan said he believes that EVAR has proved to be a valuable and life-saving technique and will be the procedure of choice for emergency treatment of ruptured aneurysms in the future.
