title: Endovascular abdominal aortic aneurysm repair (EVAR) procedures: counterbalancing the benefits with the costs.
abstract: Endovascular abdominal aortic aneurysm (AAA) repair (EVAR) is associated with lower 30-day mortality rates compared with open repair. Despite that, there are no significant differences in mortality rates between the two procedures at 2 years. On the other hand, EVAR is associated with considerably higher costs compared with open repair. The lack of significant long-term differences between the two procedures together with the substantially higher cost of EVAR may question the appropriateness of EVAR as an alternative to open surgical repair in patients fit for surgery. With several thousands of AAA procedures performed worldwide, the employment of EVAR for the management of all AAAs irrespective of the patient's surgical risk may hold implications for several national health economies. The lower perioperative mortality and morbidity rates associated with EVAR should thus be counterbalanced against the considerable costs of these procedures.
authors.forename: Kosmas I
authors.initials: KI
authors.lastname: Paraskevas
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Bessias
authors.forename: Athanasios D
authors.initials: AD
authors.lastname: Giannoukas
authors.forename: Dimitri P
authors.initials: DP
authors.lastname: Mikhailidis
mesh_terms: D017544:Aortic Aneurysm, Abdominal / Q000191:economics* / Q000401:mortality / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000191:economics* / Q000401:mortality; D003362:Cost-Benefit Analysis; D017048:Health Care Costs; D006801:Humans; D018579:Patient Selection; D018570:Risk Assessment; D013997:Time Factors; D016896:Treatment Outcome