{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:46:13Z","timestamp":1787010373051,"version":"build-2736575974"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Compare long-term mortality, secondary intervention and secondary rupture following elective endovascular aneurysm repair (EVAR) and open surgical repair (OSR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>EVAR has surpassed OSR as the most common procedure used to repair abdominal aortic aneurysm (AAA), but evidence regarding long-term outcomes is inconclusive.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We included patients in linked clinical registry and administrative data undergoing EVAR or OSR for intact AAA between January 2010 and June 2019. We used an inverse probability of treatment-weighted survival analysis to compare all-cause mortality, cause-specific mortality, secondary interventions and secondary rupture, and evaluate the impact of secondary interventions and secondary rupture on all-cause mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The study included 3460 EVAR and 427 OSR patients. Compared to OSR, the EVAR all-cause mortality rate was lower in the first 30 days [adjusted hazard ratio (HR) = 0.22, 95% confidence interval (CI) 0.140.33], but higher between 1 and 4 years (HR = 1.29, 95% CI 1.12\u20131.48) and after 4years (HR = 1.41, 95% CI 1.23\u20131.63). Secondary intervention rates were higher over the first 30 days (HR = 2.26, 95% CI 1.11\u20134.59), but lower between 1 and 4years (HR = 0.59, 95% CI 0.48\u20130.74). Secondary aortic intervention rates were higher across the entire follow-up period (HR = 2.52, 95% CI 2.06\u20133.07). Secondary rupture rates did not differ significantly (HR = 1.06, 95% CI 0.73\u20131.55). All-cause mortality beyond 1 year remained significantly higher for EVAR after adjusting for any secondary interventions, or secendary rupture<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>EVAR has an early survival benefit compared to OSR. However, elevated long-term mortality and higher rates of secondary aortic interventions and subsequent aneurysm repair suggest that EVAR may be a less durable method of aortic aneurysm exclusion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/sla.0000000000005259","type":"journal-article","created":{"date-parts":[[2021,10,20]],"date-time":"2021-10-20T21:02:50Z","timestamp":1634763770000},"page":"e955-e962","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":13,"title":["Long-Term Outcomes Following Elective Repair of Intact Abdominal Aortic Aneurysms"],"prefix":"10.1097","volume":"277","author":[{"given":"Sarah K.","family":"Garland","sequence":"first","affiliation":[{"name":"Center for Big Data Research in Health, UNSW Sydney, Australia"},{"name":"Biostatistics Training Program, NSW Ministry of Health, Sydney, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael O.","family":"Falster","sequence":"additional","affiliation":[{"name":"Center for Big Data Research in Health, UNSW Sydney, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. Barry","family":"Beiles","sequence":"additional","affiliation":[{"name":"Australian and New Zealand Society for Vascular Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony J.","family":"Freeman","sequence":"additional","affiliation":[{"name":"Australian and New Zealand Society for Vascular Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louisa R.","family":"Jorm","sequence":"additional","affiliation":[{"name":"Center for Big Data Research in Health, UNSW Sydney, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Art","family":"Sedrakyan","sequence":"additional","affiliation":[{"name":"Healthcare Policy and Research, Weill Cornell Medicine, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oluwadamisola","family":"Sotade","sequence":"additional","affiliation":[{"name":"Center for Big Data Research in Health, UNSW Sydney, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramon L.","family":"Varcoe","sequence":"additional","affiliation":[{"name":"Department of Surgery, Prince of Wales Hospital"},{"name":"Faculty of Medicine, University of New South Wales"},{"name":"The Vascular Institute, Prince of Wales Hospital, Sydney, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,10,20]]},"reference":[{"key":"R1-20250424","first-page":"123","article-title":"Samofiksiruiushchi?sia sinteticheski? 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