Patient-reported Quality of Life after Endovascular Repair of Thoracoabdominal Aortic Aneurysms.
Academic Article
Overview
abstract
BACKGROUND: The purpose of this study is to assess patient-reported physical and emotional well-being during follow-up after endovascular repair of thoracoabdominal aortic aneurysm (TAAA). METHODS: All patients were treated in the context of a physician-sponsored investigational device exemption clinical study for patients at high risk for open TAAA repair. The short form 36 (SF-36) instrument was administered preoperatively, and at 1, 6, and 12 months. Results were analyzed using paired t-tests, with subgroup comparisons to assess the impact of adverse events and technical results on quality of life. RESULTS: Twenty-two patients (77% male) with a history of prior aortic surgery (60%), chronic kidney disease (23%), and age >75 years (77%) underwent endovascular TAAA repair. The majority of patients presented with extent III (41%) or IV (41%) aneurysms. Cumulative branch/fenestration patency was 100% and 96% and 1 and 6 months, respectively. At 1 month, patients reported lower scores across most of the SF-36 domains. Scores in role functioning, vitality, and social functioning were significantly lower than preoperatively (P < 0.05). At 6 months, patient-reported outcomes improved to preoperative levels, although patients who experienced moderate or severe adverse events in the perioperative period had lower baseline physical and emotional health. CONCLUSIONS: Endovascular TAAA repair results in reduced physical and mental health in the acute setting, irrespective of technical success or adverse events. By 6 months, however, patient-reported well-being returns to baseline levels. Ongoing efforts will continue to assess the effectiveness of endovascular TAAA repair from the patient-centered standpoint.
