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Endovascular surgery for abdominal aortic aneurysm

Reading time approx. 2 minutes Published: February 16, 1999 Updated: January 30, 2002 Publication type:

SBU Assessment

Presents a comprehensive, systematic assessment of available scientific evidence for effects on health, social welfare or disability. Full assessments include economic, social and ethical impact analyses. Assessment teams include professional practitioners and academics. Before publication the report is reviewed by external experts, and scientific conclusions approved by the SBU Board of Directors.

Findings by SBU Alert

This is a translation of version 1, published on February 16, 1999. The latest version of this report is not available in English.

Abdominal aortic aneurysm can be treated using a vascular prosthesis which is placed in the aorta via another vessel (endovascular procedure). The procedure is considered to be a milder intervention for patients compared to conventional open surgery. There is moderate* scientific knowledge concerning several of the methods used in this treatment approach. Knowledge about the benefits and risks to patients is limited to open studies and short follow-up times. There is poor* scientific knowledge about the long-term effects and the cost-effectiveness of the method. Endovascular surgery should be used only in controlled studies and should be compared with the conventional method to assure the highest level of safety and acquire relevant scientific knowledge. Future studies should also include costs and the quality of life in patients. Data should also be registered in the European Quality Registry (Eurostar).

*This assessment by SBU Alert uses a 4-point scale to grade the quality and evidence of the scientific documentation. The grades indicate: (1) good, (2) moderate, (3) poor, or (4) no scientific evidence on the subject.

This summary is based on a report prepared at SBU in collaboration with Prof Jesper Swedenborg, MD PhD, The Karolinska Hospital. It has been reviewed by Assoc Prof Thomas Troëng, MD PhD, Blekingesjukhuset.

Alert is a joint effort by the Swedish Council on Technology Assessment in Health Care (SBU), the Medical Products Agency, the National Board of Health and Welfare, and the Federation of Swedish County Councils.

References

Parodi JC, Palmaz JC, Barone HD. Transfemoral Intraluminal Graft Implantations for Abdominal Aortic Aneurysms. Annals of Vascular Surgery, 1991;5:491-499.
Woodburn KR, May J, White GH. Endoluminal abdominal aortic aneurysm surgery. British Journal of Surgery, 1998; 85: 435-443.
Bengtsson H, Bergqvist D. Ruptured abdominal aortic aneurysm: a population based study. Journal of Vascular Surgery, 1993;18:74-80.
Lucarotti M, Shaw E, Poskitt K, Heather B. The Glocestershire aneurysm screening programme: The first 2 years´experience. European Journal of Vascular and Endovascular Surgery, 1993;7: 397-401.
The UK Small Aneurysm Trial Participants. Mortality results for randomised controlled trial of early elective surgery or ultrasonographic suveillance for abdominal aortic aneurysms. Lancet 1998;352:1649-55.
Armon MP, Yusuf SW, Latief K, Whitaker SC et al. British Journal of Surgery 1997; 84:178-180.
D´Ayala M, Hollier LH, Marin ML. Endovascular grafting for abdominal aortic aneurysms. Surgical clinics of North America, 1998;78:845-861.
Holzenbein J, Kretschmer G, Glanzl R, Schon A et al. Endovascular AAA treatment: expensive prestige or economic alternative? European Journal of Vascular and Endovascular Surgery, 1997, 14:265-272.

Page updated January 30, 2002