Recommendation ID

What is the effectiveness and cost effectiveness of complex endovascular aneurysm repair (EVAR) versus open surgical repair in people for whom open surgical repair is suitable for:

  • elective repair of an unruptured AAA or

  • emergency repair of a ruptured AAA?

Any explanatory notes
(if applicable)

EVAR is a widely performed non-invasive alternative to open surgical repair. However, it is more expensive. Although standard EVAR has been shown to produce no long-term benefit over open surgical repair in people with an unruptured infrarenal abdominal aortic aneurysm, it is less clear whether this is the same in people with who would need complex EVAR to repair their AAA. The committee's view was that, because current practice is subject to strong prior beliefs about the relative benefits and harms of EVAR and open surgical repair for complex AAA, randomisation is critical to provide an unbiased estimate of comparative effectiveness.

Source guidance details

Comes from guidance
Abdominal aortic aneurysm: diagnosis and management
Date issued
March 2020

Other details

Is this a recommendation for the use of a technology only in the context of research? No  
Is it a recommendation that suggests collection of data or the establishment of a register?   No  
Last Reviewed 01/03/2020