Commentary on 'thirty day outcomes and costs of fenestrated and branched stent grafts versus open repair for complex aortic aneurysms': an innovative but expensive tool requiring further evaluation.

摘要: The benefits of standard endovascular grafts (EVAR) for abdominal aortic aneurysm (AAA) have been well documented in terms 30 day mortality, length stay, and early cost-effectiveness compared with open surgical repair (OSR). However, these stent are not adapted to complex aneurysms a short neck or involving the visceral arteries. In this issue European Journal Vascular Endovascular Surgery, Michel et al. present an interesting study comparing outcomes costs f/b EVAR OSR AAA. design is that WINDOW registry, which has previously published. registry control group patients (OSR) was extracted from French National Hospital Discharge Database (PMSI). Therefore, compares at high risk receiving selected centres (the cases, n 1⁄4 268) large acceptable (controls, 1,678). Although adjustments using Charlson index improved comparison between two groups, most comorbidities could be adjusted, resulting analysis different techniques populations. Furthermore, clinical were evaluated same way groups. data cases complete case report file (CRF), where issued coding national discharge administrative database. As example, matches corresponding thoracoabdominal versus juxtarenal infra-diaphragmatic area identified “cases” by reviewing pre-operative CT scans, whereas “controls,” relied on system alone no access patients’ charts. suggested authors, available subject incentives more likely contain impact level reimbursement.