{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T15:14:24Z","timestamp":1761059664599},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2014,1,27]],"date-time":"2014-01-27T00:00:00Z","timestamp":1390780800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,1,27]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Emergency endovascular repair (EVAR) for ruptured abdominal aortic aneurysm (rAAA) may have lower operative mortality rates than open surgical repair. Concerns remain that the early survival benefit after EVAR for rAAA may be offset by late reinterventions. The aim of this study was to compare reintervention rates and cost-effectiveness of EVAR and open repair for rAAA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis was undertaken of patients with rAAA undergoing EVAR or open repair over 6 years. A health economic model developed for the cost-effectiveness of elective EVAR was used in the emergency setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty-two patients (mean age 77\u00b79 years) underwent EVAR and 85 (mean age 75\u00b79 years) had open repair of rAAA. Median follow-up was 42 and 39 months respectively. There was no significant difference in 30-day mortality rates after EVAR and open repair (18 and 26 per cent respectively; P = 0\u00b7243). Reintervention rates were also similar (32 and 31 per cent; P = 0\u00b7701). The mean cost per patient was \u20ac26 725 for EVAR and \u20ac30 297 for open repair, and the cost per life-year gained was \u20ac7906 and \u20ac9933 respectively (P = 0\u00b7561). Open repair had greater initial costs: longer procedural times (217 versus 178\u00b75 min; P &amp;lt; 0\u00b7001) and intensive care stay (5\u00b70 versus 1\u00b70 days; P = 0\u00b7015). Conversely, EVAR had greater reintervention (\u20ac156 939 versus \u20ac35 335; P = 0\u00b7001) and surveillance (P &amp;lt; 0\u00b7001) costs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>There was no significant difference in reintervention rates after EVAR or open repair for rAAA. EVAR was as cost-effective at mid-term follow-up. The increased procedural costs of open repair are not outweighed by greater surveillance and reintervention costs after EVAR.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bjs.9409","type":"journal-article","created":{"date-parts":[[2014,1,27]],"date-time":"2014-01-27T12:09:10Z","timestamp":1390824550000},"page":"225-231","source":"Crossref","is-referenced-by-count":15,"title":["Mid-term cost-effectiveness analysis of open and endovascular repair for ruptured abdominal aortic aneurysm"],"prefix":"10.1093","volume":"101","author":[{"given":"K E","family":"Rollins","sequence":"first","affiliation":[{"name":"Cambridge Vascular Unit, Box 201, Level 6, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge CB2 0QQ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Shak","sequence":"additional","affiliation":[{"name":"Cambridge Vascular Unit, Box 201, Level 6, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge CB2 0QQ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G K","family":"Ambler","sequence":"additional","affiliation":[{"name":"Cambridge Vascular Unit, Box 201, Level 6, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge CB2 0QQ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T Y","family":"Tang","sequence":"additional","affiliation":[{"name":"Cambridge Vascular Unit, Box 201, Level 6, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge CB2 0QQ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P D","family":"Hayes","sequence":"additional","affiliation":[{"name":"Cambridge Vascular Unit, Box 201, Level 6, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge CB2 0QQ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J R","family":"Boyle","sequence":"additional","affiliation":[{"name":"Cambridge Vascular Unit, Box 201, Level 6, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge CB2 0QQ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2014,1,27]]},"reference":[{"key":"2021031618021320700_bjs9409-bib-0001","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/j.jvs.2007.11.028","article-title":"Endovascular vs. open repair of acute abdominal aortic aneurysms \u2013 a systematic review and meta-analysis","volume":"48","author":"Sadat","year":"2008","journal-title":"J Vasc Surg"},{"key":"2021031618021320700_bjs9409-bib-0002","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.jvs.2011.12.067","article-title":"Endovascular vs open repair for ruptured abdominal aortic aneurysm","volume":"56","author":"Nedeau","year":"2012","journal-title":"J Vasc Surg"},{"key":"2021031618021320700_bjs9409-bib-0003","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1016\/j.jvs.2012.09.003","article-title":"Endovascular repair of ruptured infrarenal abdominal aortic aneurysm is associated with lower 30-day mortality and better 5-year survival rates than open surgical repair","volume":"57","author":"Mehta","year":"2013","journal-title":"J Vasc Surg"},{"key":"2021031618021320700_bjs9409-bib-0004","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1097\/SLA.0b013e31828d4b76","article-title":"et al.; Amsterdam Acute Aneurysm Trial Collaborators. 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