Document Detail


Influence and Critique of the EVAR 1 Trial.
MedLine Citation:
PMID:  22153023     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
This article summarizes a differing interpretation of the long-term results of the Endovascular Aneurysm Repair (EVAR) 1 Trial. The EVAR 1 Trialists' conclusions regarding the equivalence of long-term outcomes of endovascular aneurysm repair (EVAR) with those of open repair (OR) are misleading and not applicable to patients currently treated by EVAR. The reasons that the EVAR 1 Trial is misleading and casts an unfairly negative light on the superiority of EVAR are as follows: (1) The convergence of all-cause mortality curves or the "catch-up" phenomenon; (2) old technology, inexperience, and outdated secondary treatment; (3) complications were not well-defined in EVAR 1 and are not applicable to current practice; and (4) the unfair cost comparison between EVAR and OR. The implication that OR is equivalent or superior to EVAR is, therefore, a misrepresentation. EVAR is a better treatment for infrarenal aortic aneurysms in anatomically suitable patients. We believe that current standards of practice should be altered accordingly, rather than preserving the nostrums that EVAR and OR are equivalent and that EVAR has more intrinsic disadvantages.
Authors:
Benjamin W Starnes; Christopher J Kwolek; Juan C Parodi; Frank J Veith
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Seminars in vascular surgery     Volume:  24     ISSN:  1558-4518     ISO Abbreviation:  Semin Vasc Surg     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-12-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8809602     Medline TA:  Semin Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  146-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Affiliation:
Division of Vascular Surgery, University of Washington, Seattle, WA.
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