EVAR deemed “safe and effective” by national aneurysm screening programme

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According to a recent study, an endovascular approach is “safe and effective” in the treatment of abdominal aortic aneurysms detected by the National Abdominal Aortic Aneurysm Screening Programme (NAAASP). Furthermore, the investigators found no aneurysm-related mortality in those treated electively for infrarenal aneurysms, and the overall reintervention rate was “relatively low”.

These findings were recently presented by first author Katherine Stenson (St George’s Vascular Institute, London, UK) at the British Society of Endovascular Therapy 2019 Annual Meeting (27–28 June, Wotton-under-Edge, UK).

The investigators, Stenson and colleagues at St George’s Vascular Institute, began by identifying patients who underwent repair of a screen-detected aneurysm between February 2019 and 2019 from prospectively-kept records held by the NAAASP, which commenced in England in 2009 and completed implementation in 2013. They note that the programme is designed to reduce the rate of death due to ruptured aneurysm in men.

Stenson and colleagues remark that 87 cases were elective infrarenal abdominal aortic repair, of which 86 were endovascular repairs. Among these patients, there were no aneurysm-related deaths or deaths within 30 days. Furthermore, survival estimates were 100% at one year, 86.9% at five years, and 74.5% at nine years of follow-up. Fourteen of these patients (16.1%) required reintervention, 8 of which were to treat stenosis of EVAR limbs. There were no secondary ruptures in patients treated electively for infrarenal aneurysms.

Speaking to Vascular News, Stenson remarks on the significance of the present study: “At a time when EVAR is under so much scrutiny, it is important that we focus on long term outcomes and minimise the risk of reinterventions.” She continues: “This will have implications for cost effectiveness and most importantly will have a positive effect on patient safety.”

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