Abstract
Purpose: To determine if there were differences in quality of life (QOL) within the first year following EVAR for patients undergoing internal iliac embolization depending on the type of device used. Methods: Patients who underwent endovascular AAA repair were identified using a Vascular surgery database at a tertiary care center from 2002-2008. The Radiology Information System and Image Viewer were then used to identify patients who underwent preprocedural embolization prior to endovascular aneurysm repair. Nine patients had embolization with nester coils, 9 had embolization with the amplatzer vascular plug, a type of nitinol based self expanding device. Another group of 8 patients who did not undergo preprocedural embolization was used as a comparator group. These patients were contacted via telephone and answered questions regarding QOL post procedure. The Australian Vascular QOL was the tool used to measure QOL. Differences in QOL were tabulated between the groups of patients. Results: Of the 9 patients who underwent embolization with amplatzer plug, the median QOL score was 60 (p value 0.575), the median QOL for the nester coil group was 52.5 and the comparator group was 58. Separate analysis was done dividing patients into two groups, with and without comorbidities without statistical significance. Conclusion: Patients who underwent preprocedural embolization using amplatzer plugs compared to coils had higher overall QOL scores although the difference was not significant.
Highlights
Patients with abdominal aortic aneurysms (AAA) that are high risk for open repair undergo endovascular aneurysm repair (EVAR) to reduce peri operative mortality
The AUSVIQUOL developed by Borchard et al in 2006 is the first disease specific quality of life (QOL) tool for AAA patients in the clinical setting
This QOL assessment tool was intended for patients who had vascular surgery and not the general population
Summary
Patients with abdominal aortic aneurysms (AAA) that are high risk for open repair undergo endovascular aneurysm repair (EVAR) to reduce peri operative mortality. 10% - 20% of AAA involve the iliac arteries [1]. Iliac aneurysm repair can be achieved by several methods including iliac branched grafts, occlusion of the internal iliac and coverage into the external iliac with the graft limb or surgical bypass to the internal iliac artery. Therapeutic embolization of the internal iliac arteries are required in up to 20% of patients with AAA extending to the common iliac arteries prior to EVAR [2,3]. Pre-procedural occlusions can be achieved using the conventional coils or nitinol based plugs.
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