In the EVAR-1 trial comparing endovascular aneurysm repair (EVAR) to open repair of abdominal aortic aneurysm, what was the 15-year all-cause mortality finding?
- A No significant difference in all-cause mortality at 15 years between groups ✓
- B EVAR had significantly lower all-cause mortality at 15 years
- C Open repair had significantly lower all-cause mortality at 15 years
- D EVAR group had increased aneurysm-related mortality at 15 years due to endoleak complications
Correct answer: A. No significant difference in all-cause mortality at 15 years between groups
Explanation
The EVAR-1 trial (15-year follow-up published 2019) demonstrated that the initial perioperative survival advantage of EVAR was lost by 5–8 years, and there was no significant difference in all-cause mortality at 15 years. However, EVAR was associated with significantly more reinterventions due to endoleaks, sac enlargement, and device failure. Aneurysm-related mortality was slightly higher in EVAR due to secondary ruptures after endoleak. These findings support ongoing EVAR surveillance and open repair's durability advantage long-term.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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