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IMPROVE shows treatment outcomes for abdominal aortic aneurysms

last modified Nov 25, 2017 01:52 PM

The results of the IMPROVE trial for ruptured abdominal aortic aneurysms have been published in the BMJ. The trial was led by researchers from Imperial College, London with statistical analyses conducted by Dr Michael Sweeting who is also a member of the Trial Management Committee.

Previous randomised trials had shown that - compared with traditional open repair - keyhole endovascular repair does not reduce acute mortality within 90 days from the emergency surgery. The IMPROVE trial is the first randomised trial comparing the use of the keyhole endovascular aneurysm repair versus traditional open surgery with comprehensive mid-term outcomes, including re-interventions, quality of life, costs, and evaluation of cost effectiveness.

The trial took place 2009-2016 across 29 vascular centres in the UK and 1 in Canada, and assessed the three-year outcomes of the different treatment methods. 613 participants with a clinical diagnosis of ruptured aneurysm were randomised: 316 to an endovascular strategy and 297 to open repair.

The results show that despite similar mortality rates up to one year after operation, by three years an endovascular repair strategy has lower mortality, better quality of life, reduced costs and hence was cost-effective in comparison with open abdominal repair. Therefore, the findings of the IMPROVE trial support the increasing use of endovascular repair, which would be both clinically effective and cost effective.

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