Authors' objectives: To assess the available evidence on the efficacy, safety and coverage related aspects regarding the use of endovascular repair in abdominal aortic aneurysm.

Authors' recommendations: The evidence found on the use of EVAR for infrarenal AAA is plenty and of good methodological quality. EVAR did not show benefits for low risk aneurysms when compared with watchful waiting behavior. Regarding high risk aneurysms, some studies showed benefits in mortality at 30 days, but this difference did not remain at long term compared with OSR: In the case of AAA rupture, no benefit has been demonstrated for EVAR compared with OSR. The Clinical Practice Guidelines, Health Technology Assessments and coverage policies chosen, consider that in most cases, OSR is the treatment of choice and that EVAR is an alternative only for patients at high surgical and rupture risk with favorable anatomic characteristics for use. There are no randomized, controlled studies evaluating the use of EVAR in juxtarenal AAA. No Clinical Practice Guidelines or Health Technology Assessments were found mentioning this indication. One coverage policy mentions and considers it experimental, because there is not enough information on long-term effectiveness and safety.

Project Status: Completed

Year Published: 2015

URL for published report: www.iecs.org.ar/home-ets/

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Argentina

Organisation Name: Institute for Clinical Effectiveness and Health Policy

Contact Address: Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA

Contact Name: info@iecs.org.ar

Contact Email: info@iecs.org.ar

Copyright: Institute for Clinical Effectiveness and Health Policy (IECS)