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Updated: Feb 2, 2026
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Short Stay EVAR is Safe and Cost Effective
Sarah E Shaw1, Ryan Preece1, Katherine M Stenson1
1St George's Vascular Institute, St George's Hospital, London, UK.
Summary
Selected patients can safely undergo endovascular aneurysm repair (EVAR) with a short stay pathway. Monitoring for 6 hours post-operatively is sufficient, leading to significant cost savings and bed day reductions.
Area of Science:
- Vascular Surgery
- Health Services Research
- Minimally Invasive Procedures
Background:
- Reducing length of stay (LOS) post-surgery can optimize resource utilization.
- Endovascular aneurysm repair (EVAR) has low morbidity, suggesting potential for short-stay interventions.
Purpose of the Study:
- To systematically review the safety, feasibility, and cost-effectiveness of a short-stay EVAR pathway.
Main Methods:
- Systematic literature search of Ovid MEDLINE and Embase databases (1996-2018).
- Adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
- Bias assessment using the Newcastle-Ottawa Scale.
Main Results:
- Five studies including 450 patients showed 75% were discharged same or next day post-EVAR.
- Complications typically occurred within 3-6 hours; readmission rates were 0-5% with no difference in 30-day readmissions.
- Early discharge resulted in significant cost savings (£9844 for 1-day LOS vs. £13,360 for 4-day LOS).
Conclusions:
- Selected patients can safely undergo EVAR on a short-stay pathway.
- A 6-hour post-operative monitoring period is adequate for low-risk patients.
- Reducing UK EVAR LOS to 1.5 days could save ~£1.8 million annually and free 4361 bed days.
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