What is a better treatment option for patients with abdominal aortic aneurysms (AA)? Currently, there are two main options; endovascular repair (below left) or open surgical repair (below right).
Chang and his colleagues analyzed the longitudinally linked California Office of Statewide Health Planning and Development inpatient database from 2001 to 2009 with a median follow-up of 3.3 years. They studied 23,670 patients, with 52% receiving endovascular repair. Endovascular repair was associated with improved 30-day outcomes (all-cause mortality, readmission, surgical site infection, pneumonia, and sepsis), as well as significantly improved survival until 3 years postoperatively. After 3 years, mortality was higher for patients who underwent an endovascular repair. No significant difference in long-term mortality was observed for the entire cohort on adjusted analysis (hazard ratio, 0.99; 95% CI, 0.94-1.04; P = .64). Endovascular repair was found to be associated with a significantly higher rate of re-interventions and AAA late ruptures.
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