Endovascular Grafts Not Appropriate for all Abdominal Aortic Aneurysm Patients

December 19, 2002

OTTAWA - The use of endovascular grafts (EVG) for the elective repair of abdominal aortic aneurysms (AAA) is not appropriate for all patients, a technology report released today by the Canadian Coordinating Office for Health Technology Assessment has concluded.

The report synthesizes the evidence comparing the use of endovascular grafts with standard open surgical repair of AAA. The evidence suggests that the advantages of endovascular grafts (less invasive repair and quicker recovery) may be overshadowed by the rate of secondary interventions when the first repair fails, and the risks of continued aneurysm growth and possible rupture.

CCOHTA also surveyed Canadian vascular surgeons to determine the current use of EVG technology in Canada. The response rate was 81% (104/129 eligible respondents). As of March 2001, less than half (40%) had used EVG for elective AAA repair. Of surgeons not using this technique, 25% said they are not confident it offers an advantage over open repair. From the survey, it appears that EVG is being used in Canada mainly for patients who are considered moderate- to high-risk surgical candidates.

An aneurysm is a weakening in the wall of a blood vessel, most commonly an artery. The abdominal aorta is a common site for aneurysm formation. In Canada, there are approximately 270 deaths from AAAs annually. AAA repair involves positioning a graft at the site of the aneurysm to reinforce the weakened area. In traditional surgical repair, this involves major surgery, a large abdominal incision and significant hospitalization and recovery time. In EVG repair, the approach is less invasive as the graft is positioned through an incision in the femoral artery in the groin under fluoroscopic guidance.
.
This publication is available online.

For further information contact Kirk Fergusson: 613 226-2553 ext. 276