Endovascular aneurysm repair and outcome in patients unfit for open repair of abdominal aortic aneurysm (EVAR trial 2): randomised controlled trial

Lancet
EVAR trial participants

Abstract

Endovascular aneurysm repair (EVAR) to exclude abdominal aortic aneurysm (AAA) was introduced for patients of poor health status considered unfit for major surgery. We instigated EVAR trial 2 to identify whether EVAR improves survival compared with no intervention in patients unfit for open repair of aortic aneurysm. We did a randomised controlled trial of 338 patients aged 60 years or older who had aneurysms of at least 5.5 cm in diameter and who had been referred to one of 31 hospitals in the UK. We assigned patients to receive either EVAR (n=166) or no intervention (n=172). Our primary endpoint was all-cause mortality, with secondary endpoints of aneurysm-related mortality, health-related quality of life (HRQL), postoperative complications, and hospital costs. Analyses were by intention to treat. 197 patients underwent aneurysm repair (47 assigned no intervention) and 80% of patients adhered to protocol. The 30-day operative mortality in the EVAR group was 9% (13 of 150, 95% CI 5-15) and the no intervention group had a rupture rate of 9.0 per 100 person years (95% CI 6.0-13.5). By end of follow up 142 patients had died, 42 of aneurysm-related factors; overall mortality after 4 years was 64%. There was no significant differen...Continue Reading

References

Jun 8, 2002·JAMA : the Journal of the American Medical Association·Frank A LederleUNKNOWN Veterans Affairs Cooperative Study #417 Investigators

❮ Previous
Next ❯

Citations

Nov 13, 2009·Der Anaesthesist·J KnappA Walther
Jun 28, 2007·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·P HeiderH H Eckstein
Sep 6, 2008·Der Radiologe·D Vorwerk, V Ruppert
Feb 28, 2006·Cardiovascular and Interventional Radiology·John Rose
Jul 10, 2008·Cardiovascular and Interventional Radiology·Olivier PellerinMarc Sapoval
Dec 21, 2006·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·A R ZanklC P Tiefenbacher
Jan 15, 2008·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Christiane P Tiefenbacher
May 26, 2011·Langenbeck's Archives of Surgery·Alexander Hyhlik-DürrDittmar Böckler
Feb 18, 2010·Annals of Biomedical Engineering·Mital DesaiAlexander M Seifalian
Jun 1, 2010·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·W Scott Beattie
May 4, 2007·Asian Journal of Surgery·Muhammad Shafique SajidGeorge Hamilton
Jan 13, 2012·International Journal of Technology Assessment in Health Care·Georgios LyratzopoulosBruce Campbell
Jun 1, 2007·Seminars in Interventional Radiology·Jim A Reekers
Jun 1, 2007·Seminars in Interventional Radiology·James R H Scurr, Richard G McWilliams
Feb 1, 2008·The New England Journal of Medicine·Roger M Greenhalgh, Janet T Powell
Apr 13, 2010·The New England Journal of Medicine·UNKNOWN United Kingdom EVAR Trial InvestigatorsDavid Epstein
Aug 24, 2006·Annals of Surgery·David C BrewsterRichard P Cambria
Jan 25, 2007·Annals of Surgery·Jonathan GolledgeRobert Fitridge
Sep 5, 2013·Annals of Surgery·Mustafa Al-JubouriFedor Lurie
Jun 26, 2009·BMJ : British Medical Journal·S G ThompsonUNKNOWN Multicentre Aneurysm Screening Study Group
Feb 3, 2007·Postgraduate Medical Journal·M G A NorwoodR D Sayers
Jul 13, 2011·International Journal of Vascular Medicine·Jean-Eric TarrideRon Goeree
Mar 24, 2011·Circulation Journal : Official Journal of the Japanese Circulation Society·UNKNOWN JCS Joint Working Group
Dec 21, 2005·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Jean-Noël AlbertiniUNKNOWN French Powerlink Multicenter Trial Investigators
Jan 1, 2007·Future Cardiology·Timur P SaracKenneth Ouriel
Jul 12, 2012·Journal of Geriatric Cardiology : JGC·Zhong-Hua Sun
Jan 1, 2008·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Federico PiscioneMassimo Chiariello
Jan 1, 2012·Journal of Comparative Effectiveness Research·David J BallardJanet T Powell
Aug 13, 2013·Case Reports in Vascular Medicine·Stylianos KoutsiasAthanasios D Giannoukas
Apr 9, 2014·Journal des maladies vasculaires·K KaouelA Khayati
May 23, 2009·Abdominal Imaging·Jan Willem C Gratama, Roeland B van Leeuwen
May 31, 2014·Cardiovascular and Interventional Radiology·Donald M L TseRaman Uberoi
Feb 10, 2011·Nature Reviews. Cardiology·Ahmed KlinkZahi A Fayad

❮ Previous
Next ❯

Related Concepts

Related Feeds

Aneurysm

Aneurysms are outward distensions or bulges that occurs in a weakened wall of blood vessels. Discover the latest research on aneurysms here.

Aortic Aneurysm

An aortic aneurysm is the weakening and bulging of the blood vessel wall in the aorta. This causes dilatation of the aorta, which is usually asymptomatic but carries the risk of rupture and hemorrhage. Find the latest research on aortic aneurysms here.

Cardiac Aneurysm

Aneurysm refers to a bulge of the wall or lining of a vessel commonly occurring in the blood vessels at the base of the septum or within the aorta. In the heart, it usually arises from a patch of weakened tissue in a ventricular wall, which swells into a bubble filled with blood. Discover the latest research on cardiac aneurysm here.