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International Journal of Vascular Medicine
Volume 2011, Article ID 308685, 10 pages
Clinical Study

Should Endovascular Repair Be Reimbursed for Low Risk Abdominal Aortic Aneurysm Patients? Evidence from Ontario, Canada

1Programs for Assessment of Technology in Health (PATH) Research Institute, St. Joseph's Healthcare Hamilton and Department of Clinical Epidemiology & Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada L8P 1H1
2Division of Vascular Surgery, Department of Surgery, London Health Sciences Centre (LHSC), London, ON, Canada
3Division of Vascular Surgery, Department of Surgery, Faculty of Medicine, University of Western Ontario, London, ON, Canada

Received 3 February 2011; Revised 15 April 2011; Accepted 16 April 2011

Academic Editor: Bhagwan Satiani

Copyright © 2011 Jean-Eric Tarride et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. This paper presents unpublished clinical and economic data associated with open surgical repair (OSR) in low risk (LR) patients and how it compares with EVAR and OSR in high risk (HR) patients with an AAA > 5.5 cm. Design. Data from a 1-year prospective observational study was used to compare EVAR in HR patients versus OSR in HR and LR patients. Results. Between 2003 and 2005, 140 patients were treated with EVAR and 195 with OSR (HR: 52; LR: 143). The 1-year mortality rate with EVAR was statistically lower than HR OSR patients and comparable to LR OSR patients. One-year health-related quality of life was lower in the EVAR patients compared to OSR patients. EVAR was cost-effective compared to OSR HR but not when compared to OSR LR patients. Conclusions. Despite a similar clinical effectiveness, these results suggest that, at the current price, EVAR is more expensive than open repair for low risk patients.