Preferences for endovascular (EVAR) or open surgical repair among patients with abdominal aortic aneurysms under surveillance.
OBJECTIVE
There is no evidence about patient preferences for treatment of abdominal aortic aneurysms (AAA) by endovascular aneurysm repair (EVAR) or open surgical repair (OSR). This study examined patient preferences for elective future aneurysm repair and factors that may influence such preferences.


METHODS
Patients with small AAAs under ultrasound scan surveillance at two United Kingdom (UK) hospitals participated in a semi-structured telephone interview. Features of the two techniques were assessed with regard to their influence on the preferences of participants for EVAR or OSR, using a Likert scale. In addition, participants ranked the relative importance of 14 features against each other.


RESULTS
Fifty-six out of 100 eligible participants (56%) completed the semi-structured telephone interview. Of those, 84% (47 patients) said they would prefer a future EVAR repair. Patients who expressed a preference for OSR were significantly younger. Risks of major organ failure and death were most commonly judged as important features in influencing patient preference (Likert scale score 5/5). Risk of death was also most frequently ranked above all other features. Postoperative morbidity and mortality were regarded by patients as more important than the need for surveillance and risk of long-term problems with EVAR. Type of incision and radiation exposure were both given low Likert scale scores of 1/5, and the risk of sexual dysfunction was most frequently ranked as the least important feature of either operation, out of 14 other features.


CONCLUSIONS
When presented with detailed information about EVAR and OSR, most patients with small aneurysms would prefer EVAR.
Winterborn
Rebecca J
RJ
Department of Vascular Surgery, Royal Devon and Exeter Hospital, Exeter, United Kingdom. becsjazz@tiscali.co.uk
Amin
Irum
I
Lyratzopoulos
Georgios
G
Walker
Nicola
N
Varty
Kevin
K
Campbell
W Bruce
WB
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D002755:Choice Behavior; D017558:Elective Surgical Procedures; D004739:England; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D011829:Radiation Dosage; D018570:Risk Assessment; D012735:Sexual Dysfunction, Physiological / Q000209:etiology; D016896:Treatment Outcome; D014463:Ultrasonography