Total, Open Repairs Decline for Abdominal Aortic Aneurysms

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As the number of total, open abdominal aortic aneurysm repairs has decreased, the number of EVARs has increased.
As the number of total, open abdominal aortic aneurysm repairs has decreased, the number of EVARs has increased.

HealthDay News — The number of open abdominal aortic aneurysm (AAA) repairs dropped by almost 80 percent during the last decade, according to a study published in the June issue of the Journal of Vascular Surgery.

Bjoern D. Suckow, M.D., from Dartmouth-Hitchcock Medical Center in Lebanon, N.H., and colleagues used Medicare Part B claims to analyze trends in open AAA repair, endovascular aneurysm repair (EVAR), and branched-fenestrated EVAR for AAA among Medicare beneficiaries from 2003 to 2013.

The researchers found that after a peak number of 32,540 was performed in 2005, the total number of AAA repairs performed in fee-for-service Medicare patients declined by 26 percent from 31,582 to 23,421 (P < 0.001) over the study period. 

Furthermore, the number of open AAA repairs declined from 20,533 in 2003 to 4,916 in 2013 (P < 0.001). The number of EVARs increased from 11,049 in 2003 to 19,247 in 2011 (P < 0.001), but then declined to 16,362 repairs in 2013 (P < 0.001). The number of branched-fenestrated EVAR cases continued to rise following its introduction in 2011, from 335 procedures in 2011 to 2,143 procedures in 2013 (P < 0.001).

"These results suggest that open AAA repair is now performed too infrequently to be used as a metric in the assessment of hospital and surgeon quality in cardiovascular care," the authors write.

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