The Endovasculaire vs Chirurgie dans les Anévrysmes Rompus PROTOCOL trial update.
Endovascular aortic repair (EVAR) treatment for ruptured aortoiliac aneurysms (rAIA) avoids the additional surgical insult to physiology that comes with laparotomy and open repair (OR). In systematic reviews, the pooled mortality rate from rAIA after EVAR is around 20% and morbidity around 40%. The proportion of patients with rAIA treated by EVAR is steadily increasing, as most centers are adopting an EVAR as a first line therapy. However, two trials, one randomized (n = 32) and one nonrandomized, failed to demonstrate any benefit of EVAR to OR. The multicentric randomized study named ECAR (for Endosvasculaire vs Chirurgie dans les Anévrysmes Rompus) was setup on 160 patients to compare the EVAR vs OR in rAIA. The primary outcome is mortality at 1 month. The study started in January 2008 and is still in progress.
Desgranges
Pascal
P
Vascular Surgery Unit, Hopital Henri Mondor, Paris XII, Creteil, France. pascal.desgranges@hmn.aphp.fr
Kobeiter
Hicham
H
Castier
Yves
Y
Sénéchal
Mélanie
M
Majewski
Marek
M
Krimi
Amor
A
D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D001019:Aortic Rupture / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality; D005602:France; D006439:Hemodynamics; D006801:Humans; D017543:Iliac Aneurysm / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D019060:Minimally Invasive Surgical Procedures; D011446:Prospective Studies; D012107:Research Design; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome