Both are reasonable long-term options.

Durability of the early benefits of endovascular repair compared with open repair of abdominal aortic aneurysm (AAA) remains hard to pin down (JW Cardiol May 19 2010). Now, researchers from 42 Veterans Affairs medical centers present long-term follow-up data (up to 9 years; mean, 5.2) from the OVER trial involving 881 patients with AAA (mean age, 70) who were candidates for both endovascular and open repair and were randomly assigned to one or the other (JW Cardiol Dec 9 2009).

The rate of all-cause mortality (the primary endpoint) was similar in both groups (146 deaths each; 32.9% and 33.4% in the endovascular- and open-repair groups, respectively; P=0.81). A reduction in mortality associated with endovascular repair was nominally significant at 2 and 3 years (P=0.04 and 0.05, respectively), but not thereafter. Aneurysm ruptures occurred in six patients in the endovascular-repair group versus none in the open-repair group (P=0.03). The authors found a significant interaction between age and type of treatment: Survival was better with endovascular repair among patients younger than 70 but trended better with open repair among those aged 70.

CITATION(S):

Lederle FA et al. Long-term comparison of endovascular and open repair of abdominal aortic aneurysm. N Engl J Med 2012 Nov 22; 367:1988.