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• W2148575322 abstract "To assess trends in open and endovascular repair (EVAR) of intact abdominal aortic aneurysm (iAAA) and ruptured (rAAA) in the Medicare population. We identified all Medicare beneficiaries with a diagnosis of AAA who either underwent repair, or had a primary diagnosis of rupture (1995-2008). We evaluated trends in type of repair (open vs EVAR), presentation (iAAA vs rAAA), and 30-day mortality. Time trends were analyzed using regression models & associated statistical tests. TableTrends in Volume and Mortality Over Time for AAA, iAAA and rAAA by Procedure Type. There were 456, 464 patients identified: 383, 047 had iAAAs (84%) and 73, 417 had rAAAs (16%). Mean age was 75.1 years and 76% were male. Overall mortality decreased from 16 to 7.9%. Over this time period, EVAR use for iAAA rose from 0 to 25, 265 cases (77% of repairs), while open repairs dropped from 24, 634 to 7, 371. 30d mortality for EVAR dropped from 6.2 to 1.5% (trend: p < 0.01), while open mortality rose from 4.9 to 5.6% (p = 0.013). Ruptures decreased overall by 40%, nonoperative by 29%, while EVAR grew from 0 to 31%. The proportion of nonoperative rAAA rose by 17%. Overall 30-day mortality for rAAA decreased: Open 44 to 40% (p < 0.01), EVAR: 44 to 27% (p < 0.01), nonoperative: 84 to 79% (p < 0.01). Contrary to the expectation of a plateau, use of EVAR for iAAA continues to rise. EVAR for rAAA is also rising, contributing to a decreased 30-day mortality with rAAA repair. Due to a decrease in ruptures and the use of EVAR for iAAA & rAAA, overall AAA related 30-day mortality has dropped by 50%. This decline in open repair may have implications for resident training and attending experience." @default.
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• W2148575322 date "2010-06-01" @default.
• W2148575322 modified "2023-09-28" @default.
• W2148575322 title "PS4. Continued Expansion of EVAR for Intact and Ruptured Abdominal Aortic Aneurysm in the Medicare Population 1995-2008" @default.
• W2148575322 doi "https://doi.org/10.1016/j.jvs.2010.02.081" @default.
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