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首页> 美国政府科技报告 >Comparison of Endovascular and Open Surgical Repairs for Abdominal Aortic Aneurysm. Evidence Report/Technology Assessment Number 144
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Comparison of Endovascular and Open Surgical Repairs for Abdominal Aortic Aneurysm. Evidence Report/Technology Assessment Number 144

机译：腹主动脉瘤血管内和开放手术修复的比较。证据报告/技术评估编号144

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The objectives of the report are to evaluate treatment options for nonruptured abdominal aortic aneurysms (AAA); the relationship of hospital and physician volume to outcomes for endovascular repair (EVAR); affect of patient and AAA factors on outcomes; cost-benefits of treatments. Randomized controlled trials (RCT) of open surgical repair (OSR), EVAR, or active surveillance, systematic reviews, nonrandomized U.S. trials, and national registries were used to assess clinical outcomes. Volume-outcome articles published after 2000 were reviewed if they reported the relationship between U.S. hospital or physician volume and outcomes, were population-based, and the analysis was adjusted for risk factors. Cost studies included at least 50 EVAR and provided data on costs or charges, and cost-effectiveness analyses. For AAA <5.5 cm in diameter, active surveillance with delayed OSR results in equivalent mortality but lesser morbidity and operative costs due to fewer interventions compared to immediate OSR. For AAA > or = to 5.5 cm, EVAR has not been shown to improve long-term survival or health status over OSR though peri-operative outcomes are improved. EVAR does not improve survival in patients who are medically unfit for OSR. EVAR is associated with more complications, need for reintervention, monitoring, and costs compared to OSR or no intervention. U.S. RCT are needed using approved EVAR devices to evaluate patient outcomes.

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