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 Real-time feedback helps save energy and water
08.02.2017 | Otto-Friedrich-Universität Bamberg

nachricht The Great Unknown: Risk-Taking Behavior in Adolescents
19.01.2017 | Max-Planck-Institut für Bildungsforschung

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: Breakthrough with a chain of gold atoms

In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport

In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport

Im Focus: DNA repair: a new letter in the cell alphabet

Results reveal how discoveries may be hidden in scientific “blind spots”

Cells need to repair damaged DNA in our genes to prevent the development of cancer and other diseases. Our cells therefore activate and send “repair-proteins”...

Im Focus: Dresdner scientists print tomorrow’s world

The Fraunhofer IWS Dresden and Technische Universität Dresden inaugurated their jointly operated Center for Additive Manufacturing Dresden (AMCD) with a festive ceremony on February 7, 2017. Scientists from various disciplines perform research on materials, additive manufacturing processes and innovative technologies, which build up components in a layer by layer process. This technology opens up new horizons for component design and combinations of functions. For example during fabrication, electrical conductors and sensors are already able to be additively manufactured into components. They provide information about stress conditions of a product during operation.

The 3D-printing technology, or additive manufacturing as it is often called, has long made the step out of scientific research laboratories into industrial...

Im Focus: Mimicking nature's cellular architectures via 3-D printing

Research offers new level of control over the structure of 3-D printed materials

Nature does amazing things with limited design materials. Grass, for example, can support its own weight, resist strong wind loads, and recover after being...

Im Focus: Three Magnetic States for Each Hole

Nanometer-scale magnetic perforated grids could create new possibilities for computing. Together with international colleagues, scientists from the Helmholtz Zentrum Dresden-Rossendorf (HZDR) have shown how a cobalt grid can be reliably programmed at room temperature. In addition they discovered that for every hole ("antidot") three magnetic states can be configured. The results have been published in the journal "Scientific Reports".

Physicist Dr. Rantej Bali from the HZDR, together with scientists from Singapore and Australia, designed a special grid structure in a thin layer of cobalt in...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Booth and panel discussion – The Lindau Nobel Laureate Meetings at the AAAS 2017 Annual Meeting

13.02.2017 | Event News

Complex Loading versus Hidden Reserves

10.02.2017 | Event News

International Conference on Crystal Growth in Freiburg

09.02.2017 | Event News

 
Latest News

Stingless bees have their nests protected by soldiers

24.02.2017 | Life Sciences

New risk factors for anxiety disorders

24.02.2017 | Life Sciences

MWC 2017: 5G Capital Berlin

24.02.2017 | Trade Fair News

VideoLinks
B2B-VideoLinks
More VideoLinks >>>