Department of Surgery (Division of Vascular Surgery), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Vasc Endovascular Surg. 2023 Aug;57(6):555-563. doi: 10.1177/15385744231154123. Epub 2023 Feb 20.
Fenestrated endovascular repair (FEVAR) has become a widely used treatment option for complex abdominal aortic aneurysms (AAA) but long-term survival and quality of life (QoL) outcomes are scarce. This single center cohort study aims to evaluate both long-term survival and QoL after FEVAR.
All juxtarenal and suprarenal AAA patients treated with FEVAR in a single-center between 2002 and 2016 were included. QoL scores, measured by the RAND 36-Item Short Form Survey (SF-36), were compared with baseline data of the SF-36 provided by RAND.
A total of 172 patients were included at a median follow-up of 5.9 years (IQR 3.0-8.8). Follow-up at 5 and 10 years post-FEVAR yielded survival rates of 59.9% and 18%, respectively. Younger patient age at surgery had a positive influence on 10-year survival and most patients died due to cardiovascular pathology. Emotional well-being was better in the research group as compared to baseline RAND SF-36 1.0 data (79.2 ± 12.4 vs 70.4 ± 22.0; P < 0.001). Physical functioning (50 (IQR 30-85) vs 70.6 ± 27.4; P = 0.007) and health change (51.6 ± 17.0 vs 59.1 ± 23.1; P = 0.020) were worse in the research group as compared to reference values.
Long-term survival was 60% at 5-years follow-up, which is lower than reported in recent literature. An adjusted positive influence of younger age at surgery was found on long-term survival. This could have consequences for future treatment indication in complex AAA surgery but further large-scale validation is necessary.
血管腔内开窗修复术（FEVAR）已成为治疗复杂腹主动脉瘤（AAA）的广泛应用的治疗选择，但长期生存和生活质量（QoL）结果却很少见。本单中心队列研究旨在评估 FEVAR 后的长期生存和 QoL。
纳入 2002 年至 2016 年间在单中心接受 FEVAR 治疗的所有肾周和肾上 AAA 患者。使用 RAND 36 项健康调查简表（SF-36）测量 QoL 评分，并与 RAND 提供的 SF-36 基线数据进行比较。
共纳入 172 例患者，中位随访时间为 5.9 年（IQR 3.0-8.8）。FEVAR 后 5 年和 10 年的生存率分别为 59.9%和 18%。手术时患者年龄越小，对 10 年生存率的影响越积极，大多数患者死于心血管疾病。与基线 RAND SF-36 1.0 数据相比（79.2 ± 12.4 对 70.4 ± 22.0；P < 0.001），研究组的情感健康状况更好。身体机能（50（IQR 30-85）对 70.6 ± 27.4；P = 0.007）和健康变化（51.6 ± 17.0 对 59.1 ± 23.1；P = 0.020）在研究组中更差。
5 年随访时的长期生存率为 60%，低于近期文献报道。手术时年龄越小，长期生存率越高。这可能对复杂 AAA 手术的未来治疗指征产生影响，但需要进一步的大规模验证。
