Total, open repairs decline for abdominal aortic aneurysms
Bjoern D. Suckow, M.D., from Dartmouth-Hitchcock Medical Center in Lebanon, N.H., and colleagues used Medicare Part B claims to analyze trends in open AAA repair, endovascular aneurysm repair (EVAR), and branched-fenestrated EVAR for AAA among Medicare beneficiaries from 2003 to 2013.
The researchers found that after a peak number of 32,540 was performed in 2005, the total number of AAA repairs performed in fee-for-service Medicare patients declined by 26 percent from 31,582 to 23,421 (P < 0.001) over the study period. Furthermore, the number of open AAA repairs declined from 20,533 in 2003 to 4,916 in 2013 (P < 0.001). The number of EVARs increased from 11,049 in 2003 to 19,247 in 2011 (P < 0.001), but then declined to 16,362 repairs in 2013 (P < 0.001). The number of branched-fenestrated EVAR cases continued to rise following its introduction in 2011, from 335 procedures in 2011 to 2,143 procedures in 2013 (P < 0.001).
"These results suggest that open AAA repair is now performed too infrequently to be used as a metric in the assessment of hospital and surgeon quality in cardiovascular care," the authors write.
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