Purpose: This study examines the trends in abdominal aortic aneurysm (AAA) repair in the Australian private sector over the early 21st century, highlighting the shift towards endovascular surgery.
Materials and Methods: Data on infrarenal open AAA repair (OAR) and endovascular AAA repair (EVAR) procedures from January 2000 to December 2019 were retrieved from the Medicare Benefits Schedule (MBS). Population data from the Australian Bureau of Statistics were used to calculate the incidence per 100,000 population. Analysis was further broken down by age, gender, and state.
Results:
- Total Procedures: 13,193 EVARs (67%) and 6504 OARs (33%) were performed.
- Trend Shift: OAR procedures decreased from 70.5% of AAA repairs in 2000 to 15.7% in 2019, while EVAR procedures increased from 29.5% to 84.3%. EVAR surpassed OAR in frequency in 2004.
- Incidence: The overall incidence of AAA repair remained relatively stable (4.9-6.5 per 100,000 adults per year).
- Demographics: AAA repair was more common in males than females (9.7 vs 1.7 per 100,000 population) and predominantly affected older age groups. EVAR saw a 4-fold increase among males over 85 years (12.8 to 57.4 per 100,000 population), the largest rise in any group.
- EVAR
- Ratio: Increased from 0.4 to 5.4.
- State Discrepancies: There were notable differences in AAA repair trends across different states.
Conclusion: There has been a significant shift towards EVAR in the Australian private sector, across all demographics, despite stable overall AAA surgery rates. Further research is needed to compare these trends with those in the Australian public sector.
