PhD ceremony Mr. M.R. Kapma: Outcomes and costs of endovascular and open repair in patients with a ruptured abdominal aortic aneurysm

PhD ceremony: Mr. M.R. Kapma, 11.00 uur, Academiegebouw, Broerstraat 5, Groningen

Dissertation: Outcomes and costs of endovascular and open repair in patients with a ruptured abdominal aortic aneurysm

Promotor(s): prof. C.J.A.M. Zeebregts

Faculty: Medical Sciences

Endovascular Aneurysm Repair (EVAR) is feasible for treatment of Ruptured Abdominal Aortic Aneurysm (RAAA), together with conventional Open Repair (OR). This thesis describes the outcomes and costs of EVAR versus OR in RAAA. The excellent first results of this technique were analyzed. The necessary logistics for this minimally invasive technique were described. The results of risk-predicting scoring methods were studied. To evaluate the cost-effectiveness of EVAR versus OR in the treatment of RAAA two studies were performed, a Groningen study and a the Amsterdam AJAX trial.

When these two studies are evaluated together a clear view on the cost-effectiveness of EVAR in the treatment of RAAA can be postulated: a preferential strategy by EVAR for RAAA patients can be cost effective, although there will always be a role for open repair.

In conclusion: the introduction and widespread implementation of EVAR has been worthwhile in the treatment of RAAA.