Imperial College London

ProfessorJanetPowell

Faculty of MedicineDepartment of Surgery & Cancer

Visiting Professor
 
 
 
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Contact

 

+44 (0)20 8846 7312j.powell

 
 
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Location

 

4N17Charing Cross HospitalCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Sweeting:2017:10.1097/SLA.0000000000002392,
author = {Sweeting, MJ and Patel, R and Powell, JT and Greenhalgh, RM and EVAR, Trial Investigators},
doi = {10.1097/SLA.0000000000002392},
journal = {Annals of Surgery},
pages = {713--719},
title = {Endovascular repair of abdominal aortic aneurysm in patients physically ineligible for open repair: very long-term follow-up in the EVAR-2 randomized controlled trial},
url = {http://dx.doi.org/10.1097/SLA.0000000000002392},
volume = {266},
year = {2017}
}

RIS format (EndNote, RefMan)

TY  - JOUR
AB - OBJECTIVE: The aim of the study was to compare long-term total and aneurysm-related mortality in physically frail patients with abdominal aortic aneurysm (AAA) randomized to either early endovascular aneurysm repair (EVAR) or no-intervention. SUMMARY BACKGROUND DATA: EVAR-2 remains the sole randomized trial to identify whether EVAR reduces mortality in patients physically ineligible for open repair. METHODS: Between September 1999 and August 2004, 404 patients from 33 centers in the United Kingdom aged ≥60 years with AAA >5.5cm in diameter were randomized 1:1 using computer-generated sequences of randomly permuted blocks stratified by center to receive either EVAR (197) or no-intervention (207). The primary analysis compared total and aneurysm-related deaths in groups until June 30, 2015 (mean, 12.0 yrs; maximum 14.1 yrs). RESULTS: Mean follow-up until death or censoring was 4.2 years. There were 187 deaths (22.6 per 100 person-yrs) in the EVAR group and 194 (22.1 per 100 person-yrs) in the no-intervention group. By 12 years of follow-up the estimated survival was 5.3% [95% confidence interval (CI), 2.6-9.2] in the EVAR group and 8.5% (95% CI, 5.2-12.9) in the no-intervention group; there was no significant difference in life expectancy between the groups (both 4.2 yrs; P = 0.97). However, overall aneurysm-related mortality was significantly lower in the EVAR group [3.3 deaths per 100 person-yrs compared with 6.5 deaths per 100 person-yrs in the no-intervention group, adjusted hazard ratio 0.55 (95% CI, 0.34-0.91; P = 0.019)]. Patients surviving beyond 8 years were younger, with higher body mass index, estimated glomerular filtration rate, and forced expiratory volume in 1 second. CONCLUSIONS: EVAR does not increase overall life expectancy in patients ineligible for open repair, but can reduce aneurysm-related mortality.
AU - Sweeting,MJ
AU - Patel,R
AU - Powell,JT
AU - Greenhalgh,RM
AU - EVAR,Trial Investigators
DO - 10.1097/SLA.0000000000002392
EP - 719
PY - 2017///
SN - 0003-4932
SP - 713
TI - Endovascular repair of abdominal aortic aneurysm in patients physically ineligible for open repair: very long-term follow-up in the EVAR-2 randomized controlled trial
T2 - Annals of Surgery
UR - http://dx.doi.org/10.1097/SLA.0000000000002392
UR - http://hdl.handle.net/10044/1/54315
VL - 266
ER -