Systematic Review of Utilities in Abdominal Aortic Aneurysm

Abstract 

Introduction

Two main treatments exist for the repair of abdominal aortic aneurysm (AAA). Open surgical repair has been the standard treatment, but more recently endovascular aneurysm repair (EVAR) has been introduced as a less invasive technique. To compare the long-term outcomes of these, utility outcomes have been suggested to be relevant.

Objective

to review studies comparing the utility outcomes of open repair and EVAR treatment for AAA.

Design

database search with strict inclusion and exclusion criteria.

Materials and Methods

The search was performed in PubMed and EMBASE covering terms relating to AAA and utility. Studies were analysed qualitatively.

Results

10 studies of AAA met the review criteria. The comparative utility scores for the different treatments varied considerably between studies. A Canadian cohort study estimated EVAR as more favorable than open repair, while randomised controlled trials reported lower utilities with EVAR, except for one month post–surgery in the EVAR 1 trial. Furthermore, after screening for AAA, patients testing positive gave similar QoL-5D scores, but worse visual analogue scores than those testing negative.

Conclusion

There were few studies calculating utilities in AAA, with inconsistent findings. The limited reporting of data prevents in-depth analysis to explain the differences.

Keywords: Abdominal aortic aneurysm (AAA), Open repair, Endovascular aneurysm repair (EVAR), Quality of life (QoL), Utility, Health technology appraisal