More than 1000 people a year in the UK require emergency surgery to repair a ruptured abdominal aortic aneurysm. Without repair, ruptured aneurysm is nearly always fatal.
- Michael Sweeting
This is the first randomised trial comparing the use of keyhole (endovascular) aneurysm repair versus traditional open surgery to repair ruptured aneurysm, with full midterm follow-up.
Abdominal aortic aneurysm is a swelling of the aorta – the main blood vessel that leads away from the heart, down through the abdomen to the rest of the body. If the artery wall ruptures, the risk of death is high, and emergency surgery is needed.
Three recent European randomised trials showed that keyhole repair does not reduce the high death rate up to three months after surgery compared with open repair. However, mid-term outcomes (three months to three years) of keyhole repair are still uncertain.
An international research team set out to assess three year clinical outcomes and cost effectiveness of a strategy of keyhole repair (whenever the shape of the aorta allows this) versus open repair for patients with suspected ruptured abdominal aortic aneurysm who were part of the IMPROVE trial.
Dr Michael Sweeting from the Department of Public Health and Primary Care at the University of Cambridge, who was involved in the trial, says: “More than 1000 people a year in the UK require emergency surgery to repair a ruptured abdominal aortic aneurysm. Without repair, ruptured aneurysm is nearly always fatal. However, surgery is not without its own significant risks, so we are always looking at ways of reducing the risk to the patient. One option is keyhole surgery, but until now not enough was known about how its outcomes compare to regular, open surgery beyond one year after repair.”
Image: Abdominal aortic aneurysm
Credit: Arindam Chaudhuri
Reproduced courtesy of the University of Cambridge