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      Incidence of secondary rupture after abdominal aortic aneurysms (endovascular vs. open surgical repair)

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          Abstract

          A best evidence topic has been constructed using a described protocol. The three-part question addressed was: In patients with Infrarenal abdominal aortic aneurysm (AAA), Does endovascular abdominal aortic repair (EVAR), AS compared to open surgical repair (OSR), has lower secondary rupture rates? The outcomes assessed were the secondary rupture rate in both techniques. The best evidence showed that The OSR has statistically significant lower secondary rupture rates than the EVAR.

          Highlights

          • Endovascular abdominal aortic aneurysm repair is inferior to the open surgical repair regarding the secondary rupture rates.

          • Long term outcomes of the open surgical repair are better than the Endovascular repair.

          • Secondary rupture is more common in endovascular repair than the open surgical repair of abdominal aortic aneurysm.

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          Most cited references8

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          European Society for Vascular Surgery (ESVS) 2019 Clinical Practice Guidelines on the Management of Abdominal Aorto-iliac Artery Aneurysms

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            Endovascular versus open repair of abdominal aortic aneurysm in 15-years' follow-up of the UK endovascular aneurysm repair trial 1 (EVAR trial 1): a randomised controlled trial.

            Short-term survival benefits of endovascular aneurysm repair (EVAR) versus open repair of intact abdominal aortic aneurysms have been shown in randomised trials, but this early survival benefit is lost after a few years. We investigated whether EVAR had a long-term survival benefit compared with open repair.
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              Towards evidence-based medicine in surgical practice: best BETs.

              Surgeons are faced with the dilemma that many clinical questions in their daily practice to do not have universally agreed answers, but patients increasingly demand the 'best practice' from their doctors. In addition time pressures mean that clinicians are unable to keep up with the full spectrum of published research. We have adopted an approach first pioneered in emergency medicine, namely the Best Evidence Topic or Best BET. Clinicians select a clinical scenario from their daily practice that highlights an area of controversy. From this, a three-part question is generated and this is used to search Medline and other appropriate databases for relevant papers. Once the relevant papers are found, these papers are critically appraised, the relevant data to answer the question is extracted, tabulated and summarised. A clinical bottom line is reached after this process. The resulting BETs, written by practising surgeons can then provide robust evidence-based answers to important clinical questions asked during our daily practice.
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                Author and article information

                Contributors
                Journal
                Ann Med Surg (Lond)
                Ann Med Surg (Lond)
                Annals of Medicine and Surgery
                Elsevier
                2049-0801
                09 September 2021
                October 2021
                09 September 2021
                : 70
                : 102831
                Affiliations
                [a ]plymouth University Hospital NHS Trust, UK
                [b ]Aswan University Hospitals, Egypt
                Author notes
                Article
                S2049-0801(21)00781-0 102831
                10.1016/j.amsu.2021.102831
                8435911
                98c5f7b9-e9c8-40f3-b7f7-2703576de7b4
                © 2021 Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                : 12 August 2021
                : 5 September 2021
                : 5 September 2021
                Categories
                Health Economic Evaluation

                infrarenal abdominal aortic aneurysm (aaa),endovascular aneurysm repair (evar),open surgical repair (osr),secondary rupture rate

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