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Minimally Invasive Surgery Fixes Aneurysms
Date:1/30/2008

or conventional surgery. And 95 percent of those having EVAR went home from the hospital rather than to a rehabilitation facility or nursing home, compared to 80 percent of people having conventional surgery, Schermerhorn said.

"If the anatomy is good, EVAR is worth considering for any age group," Schermerhorn said. The length of the aorta beneath the arteries to the kidneys must be long enough to allow the procedure, he added.

Dr. Roy Greenberg, director of endovascular research at the Cleveland Clinic, said the new study confirms "what other trials have already shown us."

However, the new study has some shortcomings that partially offset the advantage offered by such a large database, Greenberg said. The major disadvantage is that it lumps together a very diverse group of cases, "comparing patients that are not easily comparable," he explained.

"We do an intervention in these cases not because the aneurysm is bothering patients but because we believe it will prolong patients' lives," he said. "The real question is, are we prolonging patients' lives, and we can't get an answer from this data set. There are too many compounding factors."

Still, the new report "does point out the pros and cons that are very important when we talk to patients about a procedure," Greenberg said.

Dr. Joseph Coselli, chief of adult cardiac surgery at the Texas Heart Institute, concurred that the new research confirms the short-term benefits of EVAR, at least for older patients.

"The mortality rate is lower, morbidity is clearly lower and hospitalization time, blood requirements and the ability to return home or to work are certainly less than with open surgery," he said.

But some issues haven't been completely resolved, Coselli said. "Durability of EVAR is still up in the air," he said. "And there still is a group of patients on the younger end that may yet, based on current technology, require an open operat
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