SELECTIVE MANAGEMENT OF HIGH-RISK PATIENTS WITH AN ABDOMINAL AORTIC-ANEURYSM

  • 1 January 1980
    • journal article
    • research article
    • Vol. 150  (2) , 171-176
Abstract
Patients with abdominal aortic aneurysm [187] seen during a 15 yr period were denied operation at the time of initial evaluation because of the small size of the aneurysm, serious medical contraindications or both. Seven patients were operated upon, because of rupture, 16 because of symptomatic expansion, 13 because of increase in size to greater than 6 cm and 6 because of improvement in medical status. Operative related deaths occurred in 5 of the 7 patients operated upon for rupture, 4 of the 16 patients operated upon because of symptomatic expansion and 1 of the 19 patients operated upon electively. Of the 153 patients selectively observed, 74 died during the follow-up period; 20 deaths were aneurysm related; 54 deaths were due to associated disease. Of 18 patients with a rupture of the aneurysm, 16 died as a result. In the entire group of 187 patients, the cumulative survival rate was 44% at 5 yr and 27% at 10 yr. Current management of high risk patients with abdominal aortic aneurysm is supported but there is apparently a need for more aggressive approach to patient selection.

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