The EVAR-1 trial compared endovascular aortic aneurysm repair (EVAR) with open repair for infrarenal AAA. The key finding at 15-year follow-up was:
- A EVAR had superior long-term overall survival
- B EVAR had better early perioperative survival but no long-term survival advantage ✓
- C Open repair had lower aneurysm-related mortality at 5 years
- D EVAR was associated with higher rates of renal failure due to contrast nephropathy
Correct answer: B. EVAR had better early perioperative survival but no long-term survival advantage
Explanation
EVAR-1 demonstrated that EVAR significantly reduces 30-day operative mortality (approximately 1.7% vs. 4.7%) and early aneurysm-related mortality compared to open repair. However, by 4–8 years, the survival advantage was lost due to late endoleaks, graft-related complications, and secondary interventions required in EVAR. At long-term follow-up (>8 years), open repair achieves equivalent or superior overall survival. EVAR remains preferred in high-risk patients who are unfit for open surgery.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.