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 Multi-year study finds 'hotspots' of ammonia over world's major agricultural areas
17.03.2017 | University of Maryland

nachricht Diabetes Drug May Improve Bone Fat-induced Defects of Fracture Healing
17.03.2017 | Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke

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: A Challenging European Research Project to Develop New Tiny Microscopes

The Institute of Semiconductor Technology and the Institute of Physical and Theoretical Chemistry, both members of the Laboratory for Emerging Nanometrology (LENA), at Technische Universität Braunschweig are partners in a new European research project entitled ChipScope, which aims to develop a completely new and extremely small optical microscope capable of observing the interior of living cells in real time. A consortium of 7 partners from 5 countries will tackle this issue with very ambitious objectives during a four-year research program.

To demonstrate the usefulness of this new scientific tool, at the end of the project the developed chip-sized microscope will be used to observe in real-time...

Im Focus: Giant Magnetic Fields in the Universe

Astronomers from Bonn and Tautenburg in Thuringia (Germany) used the 100-m radio telescope at Effelsberg to observe several galaxy clusters. At the edges of these large accumulations of dark matter, stellar systems (galaxies), hot gas, and charged particles, they found magnetic fields that are exceptionally ordered over distances of many million light years. This makes them the most extended magnetic fields in the universe known so far.

The results will be published on March 22 in the journal „Astronomy & Astrophysics“.

Galaxy clusters are the largest gravitationally bound structures in the universe. With a typical extent of about 10 million light years, i.e. 100 times the...

Im Focus: Tracing down linear ubiquitination

Researchers at the Goethe University Frankfurt, together with partners from the University of Tübingen in Germany and Queen Mary University as well as Francis Crick Institute from London (UK) have developed a novel technology to decipher the secret ubiquitin code.

Ubiquitin is a small protein that can be linked to other cellular proteins, thereby controlling and modulating their functions. The attachment occurs in many...

Im Focus: Perovskite edges can be tuned for optoelectronic performance

Layered 2D material improves efficiency for solar cells and LEDs

In the eternal search for next generation high-efficiency solar cells and LEDs, scientists at Los Alamos National Laboratory and their partners are creating...

Im Focus: Polymer-coated silicon nanosheets as alternative to graphene: A perfect team for nanoelectronics

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are less stable. Now researchers at the Technical University of Munich (TUM) have, for the first time ever, produced a composite material combining silicon nanosheets and a polymer that is both UV-resistant and easy to process. This brings the scientists a significant step closer to industrial applications like flexible displays and photosensors.

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

International Land Use Symposium ILUS 2017: Call for Abstracts and Registration open

20.03.2017 | Event News

CONNECT 2017: International congress on connective tissue

14.03.2017 | Event News

ICTM Conference: Turbine Construction between Big Data and Additive Manufacturing

07.03.2017 | Event News

 
Latest News

Researchers shoot for success with simulations of laser pulse-material interactions

29.03.2017 | Materials Sciences

Igniting a solar flare in the corona with lower-atmosphere kindling

29.03.2017 | Physics and Astronomy

As sea level rises, much of Honolulu and Waikiki vulnerable to groundwater inundation

29.03.2017 | Earth Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>