A study of outcomes in conservatively managed patients with large abdominal aortic aneurysms deemed unfit for surgical repair.


Journal

Vascular
ISSN: 1708-539X
Titre abrégé: Vascular
Pays: England
ID NLM: 101196722

Informations de publication

Date de publication:
Apr 2019
Historique:
pubmed: 16 10 2018
medline: 23 4 2019
entrez: 16 10 2018
Statut: ppublish

Résumé

The current advancement and increasing use of diagnostic imaging has led to increased detection of abdominal aortic aneurysms (AAA). Many of these patients are unfit for elective AAA surgery. To investigate the outcome of conservative management of unfit patients with large AAA (>5.5 cm) who are turned down for elective surgical intervention. Between January 2006 and April 2017, 457 patients presented with AAA >5.5 cm. Seventy-six patients (M: F 54:22) were deemed unfit for elective repair. Mean age was 79.8 years (range 64-96). Mean AAA size was 60.22 mm (55-83). Forty-nine of the 76 patients (64%) had died by April 2017. Fifteen (19.7%) patients died directly because of their aneurysm rupture. A further 34 (44.7%) patients died from non-aneurysm-related causes. Patients with large AAA deemed unfit for elective surgery have an overall poor prognosis and die mainly from other causes than AAA. Surgical intervention when rupture occurs results in poor survival.

Sections du résumé

BACKGROUND BACKGROUND
The current advancement and increasing use of diagnostic imaging has led to increased detection of abdominal aortic aneurysms (AAA). Many of these patients are unfit for elective AAA surgery.
AIM OBJECTIVE
To investigate the outcome of conservative management of unfit patients with large AAA (>5.5 cm) who are turned down for elective surgical intervention.
PATIENTS AND METHODS METHODS
Between January 2006 and April 2017, 457 patients presented with AAA >5.5 cm. Seventy-six patients (M: F 54:22) were deemed unfit for elective repair. Mean age was 79.8 years (range 64-96). Mean AAA size was 60.22 mm (55-83).
RESULTS RESULTS
Forty-nine of the 76 patients (64%) had died by April 2017. Fifteen (19.7%) patients died directly because of their aneurysm rupture. A further 34 (44.7%) patients died from non-aneurysm-related causes.
CONCLUSION CONCLUSIONS
Patients with large AAA deemed unfit for elective surgery have an overall poor prognosis and die mainly from other causes than AAA. Surgical intervention when rupture occurs results in poor survival.

Identifiants

pubmed: 30319068
doi: 10.1177/1708538118807075
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

161-167

Auteurs

Ahmed Elmallah (A)

Department of Vascular Surgery, St. Vincent's University Hospital, Dublin 4, Ireland.

Mohamed Elnagar (M)

Department of Vascular Surgery, St. Vincent's University Hospital, Dublin 4, Ireland.

Niamh Bambury (N)

Department of Vascular Surgery, St. Vincent's University Hospital, Dublin 4, Ireland.

Zeeshan Ahmed (Z)

Department of Vascular Surgery, St. Vincent's University Hospital, Dublin 4, Ireland.

Joseph Dowdall (J)

Department of Vascular Surgery, St. Vincent's University Hospital, Dublin 4, Ireland.

Denis Mehigan (D)

Department of Vascular Surgery, St. Vincent's University Hospital, Dublin 4, Ireland.

Stephen Sheehan (S)

Department of Vascular Surgery, St. Vincent's University Hospital, Dublin 4, Ireland.

Mary Barry (M)

Department of Vascular Surgery, St. Vincent's University Hospital, Dublin 4, Ireland.

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