Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Long-term survival from abdominal aortic aneurysm repair improving

07.07.2009
Long-term survival for patients undergoing surgical repair of intact abdominal aortic aneurysms has improved in recent decades, according to a Swedish study reported in Circulation: Journal of the American Heart Association.

An abdominal aortic aneurysm is a bulge in the main artery leading away from the heart (the aorta) that occurs below the kidneys (in the abdomen). If such a bulge bursts, hemorrhaging can occur within the abdominal cavity. These aneurysms can be monitored or corrected surgically while the bulge is intact, but require emergency surgery when ruptured.

In the new study, researchers examined patient outcomes of 8,663 operations to repair intact aneurysms and 4,171 to repair ruptured ones from 1987 to 2005. The researchers used the patients' relative five-year survival rate as a key measure. That rate excluded patients who died within 90 days of surgery and was based on a comparison of expected survival rates in a broader population with the same demographic characteristics.

Among patients whose intact aneurysms were repaired during the 18 years of the study, the relative five-year survival rate was 90.3 percent, with patients surviving an average of almost nine years after surgery.

The study found that short-term crude, or actual, survival rates improved among patients who underwent surgery to repair a ruptured abdominal aortic aneurysm. The relative survival rate held steady at about 87 percent. On average, patients who underwent repair for a ruptured aneurysm lived 5.4 years after surgery. Researchers found no significant differences in relative five-year survival rates between men and women or between age groups.

However, researchers found differences in the repair of intact aneurysms. Relative survival was 10.2 percent higher among patients in their 80s than among those age 79 and younger and 4.6 percent higher for male patients than for female patients. Researchers said the survival gap between the sexes in intact repairs may be due to higher levels of atherosclerosis (plaque buildup causing thickening of the arteries) in female versus male patients.

Patients undergoing elective repair of intact aneurysms face low risk and can look forward to close-to-normal longevity after surgery, said Kevin Mani, M.D., lead author of the study and physician at the Department of Vascular Surgery at Uppsala University Hospital in Sweden. "The fact that operative treatment for abdominal aortic aneurysm is offered to older patients, with more frequent cardiovascular disease, could have resulted in inferior long-term outcomes. But this was fortunately not the case. Accurately selected elderly patients can have excellent long-term survival after surgery."

Advances in postoperative care have helped improve both short- and long-term outcomes for patients with intact aneurysms who undergo repair, Mani said. Furthermore, a less-invasive surgical technique known as endovascular aneurysm repair (EVAR) has allowed surgical repair for greater numbers of older patients with additional health problems.

Though patients who underwent EVAR on average were older, "the results of the current study show that patients offered EVAR have the same long-term outcome — relative survival compared to the general population — as patients operated on with more invasive open surgery," Mani said.

Researchers used data from the Swedish Vascular Registry, which Mani describes as a meticulously maintained and validated database that's cross-linked to mortality data from a nationwide population registry. Patient outcomes were followed for an average of nine years.

The study's findings may not necessarily translate to other countries, however. Differences in healthcare systems and clinical decision making for patients pursuing elective abdominal aortic aneurysm repair elsewhere could yield different survival rates, Mani said, noting that elective repair and EVAR are more common in the United States than in Europe.

Nevertheless, general trends toward increased use of EVAR, treatment of older patients with more health problems and improved preventive care in people with existing heart disease are boosting long-term survival globally, he said.

Co-authors are Martin Björck, M.D., Ph.D.; Jonas Lundkvist, R.Ph., Ph.D.; and Anders Wanhainen, M.D., Ph.D.

Individual author disclosures can be found on the manuscript.

The study was funded by the Swedish Heart and Lung Foundation, the Sigurd and Elsa Golje Foundation, the Royal Society of Arts and Sciences of Uppsala and the Swedish Research Council.

Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association's policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at www.americanheart.org/corporatefunding.

Tagni McRae | EurekAlert!
Further information:
http://www.heart.org
http://www.americanheart.org/corporatefunding

More articles from Studies and Analyses:

nachricht Rutgers-led innovation could spur faster, cheaper, nano-based manufacturing
14.02.2018 | Rutgers University

nachricht New study from the University of Halle: How climate change alters plant growth
12.01.2018 | Martin-Luther-Universität Halle-Wittenberg

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: In best circles: First integrated circuit from self-assembled polymer

For the first time, a team of researchers at the Max-Planck Institute (MPI) for Polymer Research in Mainz, Germany, has succeeded in making an integrated circuit (IC) from just a monolayer of a semiconducting polymer via a bottom-up, self-assembly approach.

In the self-assembly process, the semiconducting polymer arranges itself into an ordered monolayer in a transistor. The transistors are binary switches used...

Im Focus: Demonstration of a single molecule piezoelectric effect

Breakthrough provides a new concept of the design of molecular motors, sensors and electricity generators at nanoscale

Researchers from the Institute of Organic Chemistry and Biochemistry of the CAS (IOCB Prague), Institute of Physics of the CAS (IP CAS) and Palacký University...

Im Focus: Hybrid optics bring color imaging using ultrathin metalenses into focus

For photographers and scientists, lenses are lifesavers. They reflect and refract light, making possible the imaging systems that drive discovery through the microscope and preserve history through cameras.

But today's glass-based lenses are bulky and resist miniaturization. Next-generation technologies, such as ultrathin cameras or tiny microscopes, require...

Im Focus: Stem cell divisions in the adult brain seen for the first time

Scientists from the University of Zurich have succeeded for the first time in tracking individual stem cells and their neuronal progeny over months within the intact adult brain. This study sheds light on how new neurons are produced throughout life.

The generation of new nerve cells was once thought to taper off at the end of embryonic development. However, recent research has shown that the adult brain...

Im Focus: Interference as a new method for cooling quantum devices

Theoretical physicists propose to use negative interference to control heat flow in quantum devices. Study published in Physical Review Letters

Quantum computer parts are sensitive and need to be cooled to very low temperatures. Their tiny size makes them particularly susceptible to a temperature...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

2nd International Conference on High Temperature Shape Memory Alloys (HTSMAs)

15.02.2018 | Event News

Aachen DC Grid Summit 2018

13.02.2018 | Event News

How Global Climate Policy Can Learn from the Energy Transition

12.02.2018 | Event News

 
Latest News

Researchers invent tiny, light-powered wires to modulate brain's electrical signals

21.02.2018 | Life Sciences

The “Holy Grail” of peptide chemistry: Making peptide active agents available orally

21.02.2018 | Life Sciences

Atomic structure of ultrasound material not what anyone expected

21.02.2018 | Materials Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>