Patients’ Satisfaction After Endovascular Repair of Abdominal Aortic Aneurysm

Excerpt

I found delightful the report by Bellosta et al. [1], with the cute smiling aneurysm in Fig. 3 showing that “EVAR is really better than open repair” as they state. Unfortunately, this message is far away from the real word. The quality of life was thought to be significantly higher in patients undergoing EVAR, rather than open repair, for abdominal aortic aneurysm, because it is less invasive. However, this was never demonstrated; on the contrary, many studies [2, 3] have shown that there is an early benefit only in terms of quality of life in patients undergoing EVAR. Aljabri et al. [2], using the SF-36 (approved by the American College of Surgeons and the American Society of Vascular Surgery, validated for patients with vascular diseases [4]), showed that patients undergoing EVAR return more rapidly to baseline scores postoperatively and have higher quality-of-life levels in the early postoperative period, but from 6 months on, patients undergoing open repair have significant higher quality-of-life scores compared to those with EVAR. Prinssen et al. [3] arrived at the same conclusions in the DREAM trial. They used both the SF-36 and the EuroQoL-5D questionnaires and concluded that in the early postoperative period there is a small yet significant quality-of-life advantage of EVAR compared with open repair, but at 6 months and beyond, patients have a better quality of life after open repair than after EVAR. Therefore, I am afraid that when the authors [1] see the 6-month CT scan of their patient, the aneurysm might not be smiling anymore. …