• Press Center
• Press Release Archive
• Media Kit
• Medicare AAA Screening Benefit
• Press Releases from 2008 Annual Meeting
• JVS Press Releases
• SVS Position Statements
• Contact Us

Home > Press Center > Press Releases from 2005 Annual Meeting > Minimally invasive procedures improving safety of aneurysm surgery

Contact:
Jill Goodwin
Director of Communications
312-334-2308

Minimally invasive endovascular procedures result in fewer deaths and shorter hospital stays than conventional open surgery for repairing abdominal aortic aneurysms (AAA), a potentially fatal type of artery damage, according to a the results of a study presented today at the annual meeting of the Society for Vascular Surgery in Chicago.

AAA is a weakened segment in the abdominal section of the aorta, the largest artery in the body, which carries blood away from the heart. Over time, the pressure of blood flow can cause the weakened area of the aorta to bulge like a balloon. If the weakened section bursts or ruptures, it is often fatal. Less than 15 percent of patients with ruptured AAA survive. However, if the AAA is detected before it ruptures, it is curable 95 percent of the time. In general, repair is recommended when the aneurysm has a diameter greater than two inches (5-5.5 centimeters). 

Patients with AAA may undergo open surgery, which involves an abdominal incision and replacement of the weakened part of the blood vessel with a tubelike graft, or a minimally invasive endovascular procedure known as EVAR (endovascular repair of aneurysm).  In EVAR, a catheter is threaded through the blood vessels and a graft is guided to the aneurysm site, starting from a small incision in the groin area.

EVAR has gained widespread acceptance in recent years with over 40% of aneurysm surgeries being performed this way in 2003.  This study sought to document the benefits of EVAR to patients.

The researchers concluded that EVAR is responsible for a significant reduction in the proportion of patients who die within the first 30 days after surgery, called the operative mortality rate. This reduction applied even to patients with ruptured AAA, for whom repair is generally much riskier. From 2000 to 2003, the overall operative AAA mortality declined from 5.0 percent to 3.7 percent, while mortality for open repair remained unchanged.

The study also found that patients who received EVAR benefited from shorter hospital stays as well, leaving the hospital after an average of about 3.8 days, as compared with 9.8 days for open surgery in 2003. Additionally, an average of approximately 91 percent of the patients who underwent the minimally invasive procedure went home—rather than to a skilled nursing facility--after leaving the hospital. In contrast, only about 75 percent of patients who were discharged from the hospital after open surgery went directly home.

Very elderly patients—over age 84--were most likely to receive EVAR instead of open surgery.

“Our findings support the changing practice patterns for repair of abdominal aortic aneurysms,” said Dr. Ellen D. Dillavou, lead study author from the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania. “This minimally invasive procedure is setting a new standard for treating patients with this very serious condition, and is improving aneurysm surgery results across the nation.”

The study was based on a random 5 percent sample of inpatient Medicare from 1994-2001 from the Centers for Medicare and Medicaid Services

People over the age of 55 are at an increased risk of AAA. Risk factors for cardiovascular disease, including smoking and high blood pressure, as well as a family history of AAA, also increase the risk. AAA often goes undetected and untreated because patients frequently experience no symptoms prior to rupture. It is estimated that nearly 2.7 million Americans may have an AAA but only about 200,000 are diagnosed each year. The condition can be detected through ultrasound screening.