CardioExchange Archive

CardioExchange, an NEJM practice community for medical professionals dedicated to improving cardiac patient care, was active from 2009 to 2015. CardioExchange fostered discussion between clinicians from across the globe.

May 20th, 2010

Endovascular Repair of AAA: DREAM and Reality

Confirming the recent finding of the EVAR 1 trial, the DREAM Study Group reports the results of 351 patients who underwent open or endovascular repair of abdominal aortic aneurysm (AAA). The report appears in the New England Journal of Medicine along with the print publication of the EVAR 1 and 2 trials. The six-year survival rate was similar in both groups (69.9% for open repair versus 68.9% for endovascular repair). However, open repair proved more durable: 81.9% of open-repair patients were free of secondary interventions versus 70.4% of endovascular-repair patients (P=0.03).

In an accompanying editorial, K. Craig Kent notes that in the U.S.  “more than 60% of infrarenal aneurysms are repaired by endovascular techniques.” He writes that “patients with a favorable life expectancy should consider open repair” and that “all patients should be informed of the advantages and disadvantages of endovascular repair.”

Categories: General


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