This guidance replaces the previous guidance on stent-graft placement in abdominal aortic aneurysm (Interventional Procedures Guidance no. 10, September 2003). The Interventional Procedures Advisory Committee reconsidered the procedure based on the results of a systematic review commissioned by NICE, following publication of the results of the EndoVascular Aneurysm Repair (EVAR) trials.
1.1 Current evidence on the efficacy and short-term safety of stent–graft placement in abdominal aortic aneurysm appears adequate to support the use of this procedure provided that the normal arrangements are in place for consent, audit and clinical governance.
1.2 Clinicians should ensure that patients fully understand the long-term uncertainties and the potential complications associated with this procedure. In particular, patients should understand: the risks of endovascular leaks; the possibility of secondary intervention; and the need for lifelong follow-up. Patients should be provided with clear written information. In addition, use of the Institute's information for the public is recommended.
1.3 Patient selection is important, particularly for patients who would normally be considered unfit for surgery.
1.4 Publication of long-term data would be useful. It is recommended that all patients who have the procedure are entered onto one of the existing registries.