A Randomized Trial Comparing Conventional and Endovascular Repair of Abdominal Aortic Aneurysms

• Published in: The New England journal of medicine Vol. 351; no. 16; pp. 1607 - 1618
• Main Authors: Prinssen, Monique, Verhoeven, Eric L.G, Buth, Jaap, Cuypers, Philippe W.M, van Sambeek, Marc R.H.M, Balm, Ron, Buskens, Erik, Grobbee, Diederick E, Blankensteijn, Jan D
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 14.10.2004
• Subjects: Aged; Aneurysms; Angioplasty - mortality; Aortic Aneurysm, Abdominal - mortality; Aortic Aneurysm, Abdominal - surgery; Biological and medical sciences; Blood Vessel Prosthesis; Blood vessels; Clinical trials; Elective Surgical Procedures; Female; General aspects; Humans; Male; Medical procedures; Medical sciences; Mortality; Postoperative Complications; Treatment Outcome; Vascular Surgical Procedures - methods; Vascular Surgical Procedures - mortality; Abdominal aorta; Medicine; Cardiovascular disease; Clinical trial; Repair; Aortic aneurysm; Comparative study
• ISSN: 0028-4793; 1533-4406; 1533-4406
• DOI: 10.1056/NEJMoa042002

Abdominal aortic aneurysms greater than 5 cm in diameter are usually repaired surgically. This study compared open surgical repair with endovascular repair through the femoral artery, a less invasive approach. After 30 days, mortality and rates of major complications were significantly lower with endovascular than with open repair. Although the operative mortality is decreased, longer follow-up is needed to confirm the durability of these results. This study compared open surgical repair with endovascular repair through the femoral artery. Mortality and rates of major complications were lower with endovascular repair. Elective surgical repair is indicated in patients with a large abdominal aortic aneurysm. The threshold for surgery is still a subject of debate but varies between 5.0 and 5.5 cm in diameter. 1 – 4 Endovascular repair, pioneered by Parodi and Volodos in the early 1990s, is a less invasive alternative to conventional open repair. 5 , 6 Endovascular repair usually involves two small incisions made in the groin to expose the femoral arteries. With the use of guidewires, catheters, and specially designed introducer systems, a so-called endograft is assembled inside the abdominal aortic aneurysm under fluoroscopic guidance, thus excluding the aneurysm sac without . . .