Endovascular abdominal aortic aneurysm repair versus open repair: why and why not?
Randomized clinical trials have documented clinical equipoise when comparing endovascular abdominal aortic aneurysm repair (EVAR) with open aneurysm repair (OAR). Studies using large administrative databases in the United States have documented a trend whereby the majority of patients undergoing elective abdominal aortic aneurysm (AAA) repair in the United States are being repaired using endovascular techniques. However, few specific guidelines, outside of anatomic criteria for EVAR, exist to aid the physician in determining which approach is best for the individual patient. Variables to be considered in order to determine which approach is best for the patient who requires an AAA repair include age and comorbidities, arterial anatomy, and provider characteristics.
Upchurch
Gilbert R
GR
Division of Vascular Surgery, Department of Surgery, University of Michigan Medical Center, Ann Arbor, Michigan, USA. riversu@umich.edu
Eliason
Jonathan L
JL
Rectenwald
John E
JE
Escobar
Guillermo
G
Kabbani
Loay
L
Criado
Enrique
E
D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000639:trends; D002983:Clinical Competence; D006801:Humans; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000639:trends