UK Small Aneurysm Trial
UK Small Aneurysm Trial — early elective surgery versus ultrasonographic surveillance
Doente / População Intervenção / Exposição Comparação Desfecho
In 1,090 patients aged 60–76 years with a symptomless abdominal aortic aneurysm of 4.0–5.5 cm, early elective open repair did not reduce long-term all-cause mortality compared with ultrasonographic surveillance.
N
1090
Desenho
Open-label RCT, mean follow-up 4.6 years
Desfecho
All-cause mortality
Relevância
1
ResultadoHR 0.94 (95 % CI 0.75–1.17; p=0.56), with no difference at 2, 4 or 6 years. 30-day operative mortality in the early-surgery arm was 5.8 %, producing an early survival disadvantage.
UK Small Aneurysm Trial Participants. Lancet. 1998;352(9141):1649-1655. 10.1016/S0140-6736(98)10137-X
Discussão e crítica
Open repair only, at an operative mortality that would be lower today, and it predates endovascular repair entirely. It is the foundational trial that fixed the 5.5 cm intervention threshold and legitimised surveillance below it.