The EVAR Trial 1: Has it led to a change in practice?

Objectives: To assess whether the publication of the EVAR Trial 1 (June 2005) had an impact on practice in our centre. Methods: A retrospective study of all patients undergoing abdominal aortic aneurysm (AAA) repair in Leicester, from the year before publication of EVAR Trial 1 data to the year after (July 2004 – June 2006). Data from the study period was then compared with practice over the last six years (January 2000 – December 2006). Results: The proportion of endovascular aneurysm repairs (EVARs) did not change significantly in the year following publication of EVAR Trial 1 data (52% vs 57%, p=0.64). The mean age of patients offered open repair (OR) fell in the year following publication (69 years +/− 6.68 vs 72 years +/− 5.71, p<0.05). Despite this, there was no significant change in their fitness (physiological POSSUM scores: 19.2 +/− 3.91 vs 18.2 +/− 3.74, p=0.30). There was an overall increase in the percentage of EVARs in the years 2000 (28%) to 2006 (57%). Conclusion: There was no significant difference in the percentage of EVARs between the two years of study. However, over the last six years, there has been an increasing number performed in our unit and we now do more EVARs than ORs.