Emergency endovascular aneurysm repair (eEVAR) compared to conventional open repair for ruptured abdominal aortic aneurysm

Patient or population: people diagnosed with RAAA
Setting: hospital

Intervention: eEVAR
Comparison: conventional open repair

Short‐term mortality

(30‐day or in‐hospital)

OR 0.88
(0.66 to 1.16)

Study population

366 per 1000

29 fewer per 1000
(90 fewer to 35 more)

Endoleak

(30‐day)

—

A total of 44 endoleak events occurred in 128 participants randomised to eEVAR treatment. As endoleaks are only a result of endovascular repair, meta‐analysis was inappropriate.

Complication: myocardial infarction

(30‐day)

OR 2.38
(0.34 to 16.53)

Study population

15 per 1000

20 more per 1000
(10 fewer to 183 more)

Complication: renal complications (moderate or severe)

(30‐day)

OR 1.07
(0.21 to 5.42)

Study population

197 per 1000

11 more per 1000
(148 fewer to 374 more)

Complication: respiratory failure

(30‐day)

OR 3.62
(0.14 to 95.78)

Study population

1 respiratory failure event occurred in 15 participants who were randomised to eEVAR treatment. No respiratory failure events were reported in the open‐repair group.

Complication: bowel ischaemia

(30‐day)

OR 0.37
(0.14 to 0.94)

Study population

145 per 1000

86 fewer per 1000
(122 fewer to 8 fewer)

Mortality

(6 months)

OR 0.89
(0.40 to 1.98)

Study population

305 per 1000

24 fewer per 1000
(156 fewer to 160 more)

*We calculated the assumed risk of the conventional open‐repair group from the average risk in the conventional open‐repair group (i.e. the number of participants with events divided by total number of participants of the conventional open‐repair group included in the meta‐analysis). The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval; eEVAR: emergency endovascular aneurysm repair; OR: odds ratio; RAAA: ruptured abdominal aortic aneurysm; RCT: randomised controlled trial

GRADE Working Group grades of evidence
High quality: We are very confident that the true effect lies close to that of the estimate of the effect.
Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.
Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect.
Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect.