Endovascular aneurysm repair
A graft is threaded from distal access under radiological guidance through the aneurysm sac and secured to the arterial wall above and below with an ingenious device. The sac is left and clots up.
- Showed that 30 day mortality was better with EVAR compared to open repair.short
Long-term follow-up (15 years) has now shown that the survival benefit is lost after 6 to 8 years with 1 extra death per 100 person years related to aneurysm after 8 years compared to open surgery. However the all cause mortality survival curves only diverge after 11 years. There is a higher rate of death from secondary sac rupture and cancer.
- ↑ Transfemoral intraluminal graft implantation for abdominal aortic aneurysms. Parodi JC, Palmaz JC, Barone HD. Annals of Vascular Surgery 1991;5(6):491-9
- ↑ Comparison of endovascular aneurysm repair with open repair in patients with abdominal aortic aneurysm (EVAR trial 1), 30-day operative mortality results: randomised controlled trial. Greenhalgh RM, Brown LC, Kwong GP, Powell JT, Thompson SG. The Lancet 2004;364(9437):843-8
- ↑ Prinssen M, Verhoeven EL, Buth J, Cuypers PW, van Sambeek MR, Balm R, et al. A randomized trial comparing conventional and endovascular repair of abdominal aortic aneurysms. The New England journal of medicine 2004;351:1607-18. (Direct link – subscription may be required.)
- ↑ Blankensteijn JD, de Jong SE, Prinssen M, van der Ham AC, Buth J, van Sterkenburg SM, et al. Two-year outcomes after conventional or endovascular repair of abdominal aortic aneurysms. The New England journal of medicine 2005;352:2398-405. (Direct link – subscription may be required.)
- ↑ Patel R, Sweeting MJ, Powell JT, Greenhalgh RM. Endovascular versus open repair of abdominal aortic aneurysm in 15-years' follow-up of the UK endovascular aneurysm repair trial 1 (EVAR trial 1): a randomised controlled trial. Lancet (London, England). 2016 Nov; 388(10058):2366-2374.(Print-Electronic) (Link to article – subscription may be required.)