Pain and quality of life assessment after endovascular versus open repair of abdominal aortic aneurysms in patients at low risk.
OBJECTIVE
To compare functional autonomy, quality of life (QOL), and pain control after endovascular and open repair (OR) of abdominal aortic aneurysms.


METHODS
Forty patients with a low surgical risk profile and anatomic compatibility for stent-graft therapy were randomized to receive OR or endovascular aneurysm repair (EVAR). Technical and clinical success as well as mortality were assessed in both groups and compared by Kaplan-Meier analysis. Functional autonomy and QOL were assessed by Karnofsky score and Short Form 36 (SF-36) questionnaire. Pain control was assessed by a numeric rating scale and Brief Pain Inventory questionnaire. QOL outcomes by means of the SF-36 and pain questionnaires were compared with use of mixed-effects models for repeated-measures analysis.


RESULTS
All procedures were technically successful in both groups. Three late clinical failures requiring surgical conversion or repeated intervention were observed in the EVAR group and one was observed in the OR group. There was no significant difference between groups in terms of functional autonomy or QOL. No difference in pain level was evident during the early postoperative period, whereas the pain level was lower in the OR group after 1 month. Opioid analgesic drug consumption was significantly greater in the OR group during the postoperative period. Mean hospitalization duration was shorter in the EVAR group than in the OR group (4.5 days +/- 2.4 vs 11.5 days +/- 8.1; P= .001).


CONCLUSIONS
EVAR has no advantage over OR in patients at low risk in terms of functional autonomy, QOL, and pain control. However, EVAR was associated with shorter hospitalization durations compared with OR.
Soulez
Gilles
G
Department of Radiology, Université de Montréal, Montreal, Québec, Canada.
Thérasse
Eric
E
Monfared
Amir Abbas Tahami
AA
Blair
Jean-Francois
JF
Choiniére
Manon
M
Elkouri
Stéphane
S
Stéphane
Elkoury
E
Beaudoin
Nathalie
N
Giroux
Marie-France
MF
Cliche
Andrée
A
Lelorier
Jacques
J
Oliva
Vincent L
VL
D000368:Aged; D000800:Angioplasty, Balloon; D017544:Aortic Aneurysm, Abdominal / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D010147:Pain Measurement; D010359:Patient Readmission; D011182:Postoperative Care; D011788:Quality of Life; D015607:Stents; D015996:Survival Rate