When Your Aneurysm Needs Surgery

Endovascular repair of ruptured abdominal aortic aneurysms have lower five-year mortality rates

(RxWiki News) Treating aneurysms requires surgery. Aneurysms are areas of the aorta that are swollen and weakened. If the aneurysm isn't operated on, it can rupture and lead to death.

A recent study found that patients with abdominal aortic aneurysms had lower mortality rates when they received endovascular versus open repair.

Endovascular repair involves using a stent graft to support the section of the aorta weakened by the aneurysm. The stent graft reinforces the wall of the aorta. It helps keep the aneurysm from rupturing.

Both repair procedures, endovascular and open repair, are surgical treatments to treat aneurysms using grafts. The difference is that, with endovascular, the stent graft can be inserted through an artery and delivered to the aneurysm area. Open repair involves opening up the aorta and sewing in a graft at the aneurysm site.

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Dr. Manish Mehta, MD,  of Albany Medical College and the Vascular Group, and colleagues led the study to see which procedure, endovascular versus open repair, had lower mortality rates.

Participants in the study were patients at Albany Medical Center. The endovascular group had 120 patients and the open repair group had 163.

Researchers found that the use of endovascular repair of aneurysms versus open repair had lower mortality rates at 30 days and at 5 years post repair.

At 30 days, the mortality rate was 24.2 percent for the endovascular group versus 44.2 percent for the open repair group. At 5 years, the survival rate for endovascular repair was better, in that the endovascular group had a 37 percent survival rate versus the open repair at 26 percent.

Men tended to do better with endovascular compared to women, 20.9 percent versus 32.4 percent mortality rates. Patients over 80 years old had higher mortality rates with endovascular but not open repair.

While endovascular repair patients had better overall health outcomes, 23 percent had to have a second procedure because of leaks or movement of the stent graft.

This study, entitled Endovascular repair of ruptured infrarenal abdominal aortic aneurysm is associated with lower 30-day mortality and better 5-year survival rates than open surgical repair, was published in the Journal of Vascular Surgery. It was supported by the Center for Vascular Awareness. The authors disclosed that Dr. Mehta is a speaker/consultant and on the advisory board for Cordis Corporation. Dr. Mehta is also a speaker/consultant for TriVascular, Inc., ev3 Endovascular, Inc., W.L. Gore and Associates, Inc., Medtronic, Inc., CardioMEMS, inc.,and Aptus Endosystems, Inc. These companies make or represent makers of endovascular products.

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Review Date: 
January 5, 2013