Our Summary

This research paper explores the best way to treat a specific type of aneurysm (a bulging, weak area in the wall of an artery), specifically, ruptured abdominal aortic aneurysms. The two treatment options compared are endovascular aneurysm repair (EVAR) and open surgical repair (OSR).

The researchers looked at six studies published between 2010 and 2020, which included a total of 6731 patients. They found that patients who were treated with EVAR had a lower risk of dying around the time of the operation than those who underwent OSR. EVAR patients also had a lower risk of kidney damage and needing early follow-up surgery related to the aneurysm. They also spent less time in the hospital. However, the researchers note that the quality of evidence for these findings isn’t very strong.

Overall, the research suggests that EVAR might be a better option than OSR for treating ruptured abdominal aortic aneurysms, at least in terms of reducing the risk of death around the time of surgery.

FAQs

  1. What are the two treatment options discussed for ruptured abdominal aortic aneurysms?
  2. What are some of the benefits of endovascular aneurysm repair (EVAR) compared to open surgical repair (OSR) according to the research?
  3. How strong is the evidence behind the researchers’ findings on the benefits of EVAR compared to OSR?

Doctor’s Tip

One helpful tip a doctor might give a patient about aortic aneurysm repair is to discuss with their healthcare provider the different treatment options available, such as endovascular aneurysm repair (EVAR) and open surgical repair (OSR), to determine the best approach for their specific situation. It’s important to weigh the potential benefits and risks of each option and make an informed decision based on individual factors such as age, overall health, and the size and location of the aneurysm. Regular follow-up appointments and monitoring are also crucial to ensure the aneurysm is stable and not at risk of rupture.

Suitable For

Patients who are typically recommended aortic aneurysm repair include those with aortic aneurysms that are at risk of rupture or growing rapidly. This may include patients with abdominal aortic aneurysms, thoracic aortic aneurysms, or aortic aneurysms in other locations. Patients who have symptoms related to their aneurysm, such as abdominal or back pain, may also be recommended for repair.

In the case of ruptured abdominal aortic aneurysms specifically, patients who are hemodynamically stable and able to undergo surgery are typically recommended for repair. The decision between EVAR and OSR may depend on various factors, including the size and location of the aneurysm, the patient’s overall health and risk factors, and the expertise of the healthcare team.

It is important for patients to discuss their treatment options with their healthcare providers to determine the most appropriate course of action for their specific situation.

Timeline

Before aortic aneurysm repair:

  • Patient may experience symptoms such as abdominal or back pain, a pulsating feeling in the abdomen, or other signs of an aneurysm
  • Patient undergoes diagnostic tests such as ultrasound, CT scan, or MRI to confirm the presence of an aneurysm
  • Patient may be monitored closely to track the size and growth of the aneurysm

After aortic aneurysm repair:

  • Patient undergoes surgery, either EVAR or OSR, to repair the aneurysm
  • Recovery period in the hospital, where patients are monitored for complications and given pain medications
  • Follow-up appointments with healthcare providers to ensure proper healing and monitor for any signs of recurrent aneurysm
  • Rehabilitation or physical therapy to regain strength and mobility
  • Long-term monitoring to ensure the aneurysm does not return or cause further complications.

What to Ask Your Doctor

Some questions a patient should ask their doctor about aortic aneurysm repair include:

  1. What are the risks and benefits of endovascular aneurysm repair (EVAR) compared to open surgical repair (OSR) for my specific case?
  2. What is the success rate of each procedure in treating aortic aneurysms?
  3. How long is the recovery time for each procedure?
  4. Will I need follow-up procedures or monitoring after the initial repair?
  5. What are the potential complications or side effects of each procedure?
  6. How often will I need to have imaging tests to monitor the repaired aneurysm?
  7. What lifestyle changes or medications will I need to take after the procedure?
  8. How experienced are you in performing both EVAR and OSR procedures?
  9. Are there any alternative treatment options for my aortic aneurysm?
  10. What is the long-term outlook for patients who undergo EVAR or OSR for aortic aneurysm repair?

Reference

Authors: Alsusa H, Shahid A, Antoniou GA. Journal: Vascular. 2022 Aug;30(4):628-638. doi: 10.1177/17085381211025168. Epub 2021 Jun 14. PMID: 34126813