Comparison of minimal incision aortic surgery with endovascular aortic repair

Background Enthusiasm for endovascular aortic repair (EVAR) has been tempered by midterm outcomes that raise valid concern about long-term durability. Methods This article compares outcome data from a prospective nonrandomized comparison of a less-invasive open surgical repair technique—minimal incision aortic surgery (MIAS)—and EVAR. Results MIAS and EVAR had comparable intensive care unit stays (1 day or less), quick return to general dietary feeding (2 days), and comparable hospital length of stay (4.8 days [3.4 days for uncomplicated cases MIAS] and 2.0 days for EVAR). Overall morbidity and mortality for MIAS and EVAR were comparable (18% versus 27%). MIAS was more cost effective than EVAR (net revenue MIAS = +$8,445, EVAR −$7,263) Conclusions MIAS is a safe, cost-effective alternative to endovascular aortic repair