Endovascular repair is not worse than open repair of abdominal aortic aneurysms

doi:10.1136/bmj.331.7524.1081

BMJ 2005;331:1081 (5 November), doi:10.1136/bmj.331.7524.1081

Letter

Endovascular repair is not worse than open repair of abdominal aortic aneurysms

The first 150 words of the full text of this article appear below.

EDITOR—The title and interpretation of the EVAR trialresults in the POEM are misleading and incorrect.¹ Mortalityfigures were quoted both as aneurysm related and all cause deaths.The 30 day mortality was 1.7% in the EVAR group, which is significantlylower than 4.7% in the open repair group. Surprisingly, thePOEM somehow interpreted 30 day mortality to be less than 1%for both groups, which is clearly an error. The confidence intervals(odds ratio 0.35, 95% confidence interval 0.16 to 0.77, P =0.009) make type I error unlikely. If preintervention deathsare added to the figures 30 day mortality was calculated at3.5% for endovascular repair and 7.1% for open surgery.²

The advantage of endovascular repair is sustained at four years,with 4% aneurysm related deaths in the EVAR group compared with7% in the open repair group. This confers a 3% absolute reductionin aneurysm . . . [Full text of this article]

Jeremy Crane, specialist registrar

j.crane@imperial.ac.uk
Regional Vascular Unit, St Mary's Hospital, London W2 1NY

Meryl Davies, specialist registrar, Nick Cheshire, professor of vascular surgery

Regional Vascular Unit, St Mary's Hospital, London W2 1NY