An abdominal aortic aneurysm is a potentially fatal bulge in the aorta, the main blood vessel from the heart, where it runs through the abdomen. Researchers in the United Kingdom studied a new, less-invasive technique for repairing these aneurysms, in which surgeons make a few small incisions and feed grafts through the arteries rather than cutting the abdomen wide open to get at the diseased area.
What the researchers wanted to know: Does a less invasive way of repairing abdominal aortic aneurysms work as well as open surgical repair?
What they did: At centers in the United Kingdom where surgeons had experience in the new method, patients who needed an aneurysm repaired were randomly assigned to get the new method or old-fashioned open surgery. A little over half of the 2,068 qualified patients agreed to join the study; qualified patients were those whose aneurysm was 5.5 centimeters across or bigger and were healthy enough for surgery.
What they found: The less invasive surgery worked better in the short term; 1.7 percent of patients who had the less invasive surgery died within 30 days, compared with 4.7 percent of patients who had open surgery. But patients who had endovascular aneurysm repair, the less-invasive technique, needed more other surgeries done. This study didn't look at long-term survival after the procedures.
What the study means to you: Endovascular aneurysm repair, the less-invasive technique, seems to work better in the short term, but the researchers say it's too early to recommend this surgery for everyone with a large aneurysm.
Caveats: It's still not clear which patients might benefit most from this procedure.
Find out more: Abdominal aortic aneurysms from Medline
Read the article: The EVAR trial participants. "Comparison of Endovascular Aneurysm Repair With Open Repair in Patients with Abdominal Aortic Aneurysm (EVAR Trial 1), 30-Day Operative Mortality Results: Randomised Controlled Trial." The Lancet. Sept. 4, 2004, Vol. 364, pp. 843-848.
Abstract online: www.ncbi.nlm.nih.gov