Aneurysm deaths fall as EVAR increases

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Elective repair for abdominal aortic aneurysms is on the rise in the USA, yet total related deaths continue to decline since the introduction of endovascular repair (EVAR), according to an ongoing, long-term research report.

The study evaluates the overall annual number of aneurysm repairs, abdominal aortic aneurysm-related deaths, and mortality rates for both elective and rupture repair, rupture diagnoses without repair, as well as the effect of endovascular repair on the annual volume of aneurysm repair and its impact on rupture occurrence.

 

The updated research is published in the March 2009 issue of the Journal of Vascular Surgery.


“We have found that use of EVAR, which was approved by the Food and Drug Administration in 1999, has increased steadily,” said senior author Marc Schermerhorn, assistant professor of surgery, Harvard Medical School and section chief of endovascular surgery at the Beth Israel Deaconess Medical Center department of vascular surgery.


“In 2005 [endovascular repair] accounted for 56% of repairs, yet only 27% of the deaths for intact repairs.”


The overall number of related deaths (intact repair, ruptured repair, unrepaired ruptures) from 1993 to 2005 was 79,955, and the number of annual deaths decreased by 38%.


The updated study showed that by 2005, the mean annual number of intact repairs increased from 36,122 in the pre-endovascular era (1993-1998) to 38,901 in the period 2001-2005.


Despite the increase in repairs, the mean annual number of deaths related to intact abdominal aortic aneurysms repair decreased from 1,693 pre-endovascular to 1,207.


Mortality for all intact aneurysm repair had decreased from 4% to 3.1%, yet open repair mortality remained unchanged.


Journal of Vascular Surgery