Journal Article

Immediate Repair Compared with Surveillance of Small Abdominal Aortic Aneurysms

Ballard, David J, Cambria, Robert A, Messina, Louis M, Acher, Charles W, Gordon, Ian L, Sparks, Steven, Barone, Gary W, Krupski, William C, Ansel, Howard J, Graham, Linda M, Moneta, Gregory L, Bandyk, Dennis, Makhoul, Raymond G, Rapp, Joseph H, Chute, Edmund P, Reinke, Donovan B, Eton, Darwin, Wilson, Samuel E, Johnson, Gary R, Busuttil, Steven J, Freischlag, Julie A, Lederle, Frank A, Littooy, Fred N, Makaroun, Michel S

2002

Overview

Whether clinically stable small abdominal aortic aneurysms should be surgically repaired or monitored with periodic noninvasive imaging is controversial. This study compared the two approaches in patients with aneurysms 4.0 to 5.4 cm in diameter. After a mean follow-up of nearly five years, there was no survival advantage associated with immediate surgical repair. This study compared the two approaches in patients with aneurysms of 4.0 to 5.4 cm. There was no survival advantage with immediate surgical repair. Each year in the United States, 9000 deaths result from rupture of abdominal aortic aneurysms. 1 Another 33,000 patients undergo elective repair of asymptomatic abdominal aortic aneurysms to prevent rupture, which results in 1400 to 2800 operative deaths. 2 , 3 Because most abdominal aortic aneurysms never rupture, 4 elective repair is undertaken only when the risk of rupture is considered high. The strongest known predictor of rupture is the maximal diameter of the aneurysm. 5 , 6 Elective repair has been recommended for patients with aneurysms of 4.0 cm or more in diameter who do not have medical contraindications, 7 although others have advocated the use . . .

• Publisher: Massachusetts Medical Society
• Subject: Abdomen / Aged / Aneurysms / Aortic Aneurysm, Abdominal - diagnostic imaging / Aortic Aneurysm, Abdominal - mortality / Aortic Aneurysm, Abdominal - surgery / Aortic Rupture - etiology / Aortic Rupture - mortality / Biological and medical sciences / Blood and lymphatic vessels / Cardiology. Vascular system / Diseases of the aorta / Elective Surgical Procedures - mortality / Female / Follow-Up Studies / Humans / Male / Medical sciences / Middle Aged / Surgery / Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases / Survival Analysis / Tomography, X-Ray Computed / Ultrasonography / Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels