A randomized trial comparing conventional and endovascular repair of abdominal aortic aneurysms.

@article{Prinssen2004ART,
  title={A randomized trial comparing conventional and endovascular repair of abdominal aortic aneurysms.},
  author={Monique Prinssen and Eric L.G. Verhoeven and J. Buth and Philippe W. M. Cuypers and Marc R.H.M. van Sambeek and Ron Balm and Erik Buskens and Diederick E. Grobbee and Jan D. Blankensteijn},
  journal={The New England journal of medicine},
  year={2004},
  volume={351 16},
  pages={
          1607-18
        }
}
BACKGROUND Although the initial results of endovascular repair of abdominal aortic aneurysms were promising, current evidence from controlled studies does not convincingly show a reduction in 30-day mortality relative to that achieved with open repair. METHODS We conducted a multicenter, randomized trial comparing open repair with endovascular repair in 345 patients who had received a diagnosis of abdominal aortic aneurysm of at least 5 cm in diameter and who were considered suitable… 

Figures and Tables from this paper

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The results were not consistent with the findings of worse performance of endovascular repair with respect to long-term survival that was seen in the two European trials, and the number of patients who underwent secondary therapeutic procedures was noted.

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References

SHOWING 1-10 OF 33 REFERENCES

Elective endovascular versus open surgical repair of abdominal aortic aneurysms: systematic review of short-term results.

Endovascular repair results in less blood loss, shorter intensive care unit and hospital stays, lower 30-day mortality, and lower systemic and/or remote complication rates than those of open surgical repair.

A cost-effectiveness analysis of standard versus endovascular abdominal aortic aneurysm repair.

Endovascular repair continues to be more expensive than standard open repair determined according to procedural and follow-up costs.

Abdominal aortic aneurysms: elective endovascular repair versus conventional surgery--evaluation with evidence-based medicine techniques.

Elective endovascular repair has short-term benefits compared with surgery and cost more than surgery and there is slight, if any, difference in mortality.

Long-term outcomes of immediate repair compared with surveillance of small abdominal aortic aneurysms.

Among patients with a small abdominal aortic aneurysm, the United Kingdom Small Aneurysm Trial found no long-term difference in mean survival between the early-surgery and surveillance groups, although after eight years, total mortality was lower in theEarly-sur surgery group.

Abdominal aortic aneurysms: cost-effectiveness of elective endovascular and open surgical repair.

Endovascular repair is a cost-effective alternative compared with open surgery for the elective repair of AAA, however, the benefits and cost-effectiveness are highly dependent on uncertain outcomes, particularly long-term failure and rupture rates.