HealthDay News — Minimally-invasive surgery to repair an abdominal aortic aneurysm appears to boost survival in the short term more than traditional surgery does, but that advantage diminishes over time, according to a New England Journal of Medicine study.
Marc Schermerhorn, MD, of Harvard Medical School in Boston, and colleagues collected data on 39,966 Medicare patients who had had either open repair or endovascular repair of an abdominal aortic aneurysm. These repairs occurred from 2001 through 2008, and the patients were followed through 2009. Overall, 1.6% of the patients who had endovascular repair died around the time of the procedure, compared with 5.2% of those who underwent open repair. The number of patients who died around the time of an endovascular procedure continued to decline from 2001 to 2008. In addition, more patients opted for endovascular repair over that period, the researchers found.
During the three years after the procedure, the rate of survival was significantly higher in patients who had endovascular repair compared to those who had open repair. After three years, the rate of survival was similar for both, the researchers reported. However, after three years, complications related to the aneurysm were more common after endovascular repair. In the same period, complications related to the surgery itself were more common among those who underwent open repair.
During the eight years of follow-up, rupture of the aneurysm occurred in 5.4% of patients after endovascular repair, compared with 1.4% of patients after open repair. Two years after endovascular repair, the rate of total reinterventions decreased from 10.4% among patients who had the procedure in 2001 to 9.1% for those who had the repair in 2007, the researchers added.
1. Schermerhorn M, et al. N. Engl. J. Med. 2015; doi: 10.1001/jamapsychiatry.2015.0803.