NICE medical technologies guidance addresses specific technologies notified to NICE by sponsors. The 'case for adoption' is based on the claimed advantages of introducing the specific technology compared with current management of the condition. This case is reviewed against the evidence submitted and expert advice. If the case for adopting the technology is supported, then the technology has been found to offer advantages to patients and the NHS. The specific recommendations on individual technologies are not intended to limit use of other relevant technologies which may offer similar advantages.
1.1 The case for adopting the E‑vita open plus for treating complex aneurysms and dissections of the thoracic aorta, in a carefully selected group of people, is supported by the evidence.
1.2 Using the E‑vita open plus could remove the need for a second procedure and the associated risk of serious complications, and it should therefore be considered for people:
who would otherwise need a 2-stage repair procedure because their aortic disease extends into or beyond the distal part of their aortic arch (into the proximal descending aorta), but
who would not need additional intervention (such as stent grafting) in the descending aorta.
1.3 The E‑vita open plus is estimated to generate cost savings compared with current 2-stage repair from about 2 years after the procedure. The estimated cost saving per patient at 5 years after the procedure is around £13,334 when compared with 2‑stage repair involving open insertion of a vascular graft, £10,225 when compared with 2‑stage repair involving endovascular stent grafting and £12,536 when compared with open surgical debranching followed by endoluminal stent grafting. At 10 years after the procedure, the estimated cost savings range from around £22,704 to £29,210 across the 3 comparators. [2018 – see section 5.23]