Aortic & peripheral vascular disease

Comparison of Unibody and Non-Unibody Endografts for Abdominal Aortic Aneurysm Repair in Medicare Beneficiaries: The SAFE-AAA Study

CirculationPublished Retrospective cohort study

Main findingResult — go to the resultHazard ratio 1.19 95% CI 1.15–1.22

Authors' conclusion

In the SAFE-AAA Study, unibody aortic stent grafts failed to meet noninferiority compared with non-unibody aortic stent grafts with respect to aortic reintervention, rupture, and mortality.

Study context

Population
Medicare beneficiaries undergoing aortic stent grafting for AAA at US hospitals, procedures August 1, 2011–December 31, 2017
Participants
87,163 beneficiaries2,146 US hospitals
Exposure
Unibody vs non-unibody aortic stent grafts
  • Unibodyn = 11,903
Outcome
Composite of:
  • Aortic reintervention
  • Rupture
  • Mortality
Follow-up
Through December 31, 2019
Methodological detailsprespecified, noninferiority, inverse probability weighting
  • Prespecified
  • Noninferiority
  • Inverse probability weighting

Main finding

As reported in the abstract

median follow-up, 3.4 years

Hazard ratio

1.19

95% CI 1.15–1.22

noninferior P value of 1.00

By group

Unibodyvs Non-unibody
HR 1.19 (95% CI 1.15–1.22); noninferior P value of 1.00

Observational data: associations, not effects.

Further findings

OutcomeUnibodyNon-unibodyHR (95% CI)
Primary end point, contemporary unibody grafts (AFX2) subgroup, February 22, 2016–December 31, 2017Prespecified subgroup · cumulative incidence37.5%32.7%1.06 (0.98–1.14)

Falsification end points (HF, stroke, pneumonia)

Negligibly different between groups

Original publication

Comparison of Unibody and Non-Unibody Endografts for Abdominal Aortic Aneurysm Repair in Medicare Beneficiaries: The SAFE-AAA Study. Circulation. Published 3 March 2023. doi:10.1161/circulationaha.122.062123

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