A large-scale research study on the mortality benefits of minimally invasive vascular surgery showed little survival difference with traditional open abdominal aortic aneurysm repair surgery over open surgery. The Open Versus Endovascular Repair study brings some traditional assumptions about endovascular surgery into question. There may be little benefit for endovascular abdominal aortic aneurysm repair surgery over other open-abdominal operations.
The new Open Versus Endovascular Repair study comprises 881 patients. Results from the study showed similar mean survival times for patients undergoing endovascular and traditional open-abdominal surgeries. This new study corroborates data found in a variety of previous studies. While endovascular repair surgeries are an effective way to mitigate suffering and pain, they do not reduce mortality in the long-term. However, endovascular procedures can reduce mortality in the short term.
Several large meditech companies are currently working on endovascular repair technologies. This includes companies like Johnson & Johnson and Medtronic. Johnson & Johnson is currently developing an AAA stent graft under its Endurant brand. Medtronic is developing an AAA technology under the Incraft brand, manufactured by subsidiary Cordis. This latest mortality study may dampen some expectations for future growth of this industry.
There are several important conclusions for this study. In the future, patient preference may play a larger role in the selection of open surgery vs endovascular repair surgeries. In addition, older patients who don’t qualify for open surgery may not be eligible for an endovascular procedure.
Beckman JA. Is the dream of EVAR over? N Engl J Med 2012; 367:2041-2043. Available at: http://www.nejm.org
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