More patients are treated for nonruptured abdominal aortic aneurysms, but the proportion of women remains unchanged

Larsson, Emma; Granath, Fredrik; Swedenborg, Jesper; Hultgren, Rebecka

doi:10.1016/j.jvs.2008.05.016

Cited by 25 publications

(31 citation statements)

References 39 publications

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“…It is clear that the number of aged patients is high among the untreated in this and other series. In our study, the difference in mean age in untreated and treated was 5 years, which is in the range of 3–6 years found in previous studies [1, 12, 13, 16]. In our study, the age difference between men and women who were untreated was only 2 years, compared to the 5-year age difference in treated, which implies that age is an important factor when the decision to operate or not is made, more than gender.…”

Section: Discussionsupporting

confidence: 70%

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A Majority of Admitted Patients With Ruptured Abdominal Aortic Aneurysm Undergo and Survive Corrective Treatment: A Population‐Based Retrospective Cohort Study

et al. 2016

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BackgroundAbdominal aortic aneurysm (AAA) is an asymptomatic, potentially lethal condition predominantly found in elderly. The mortality is 100 % if rupture occurs and left untreated, but even in treated patients the mortality is substantial. Female sex and treatment with open repair rather than endovascular aortic repair (EVAR) have been reported to negatively affect outcome. The objective was to describe the contemporary care and outcome of all treated and untreated patients with ruptured AAA (rAAA) admitted to hospital.MethodPopulation-based retrospective investigation, including all patients admitted to the emergency departments within Stockholm County diagnosed with rAAA 2009–2013. All identified patients’ charts (n = 297) were analyzed; the study cohort includes 283 verified patients.ResultsMen were in majority [214 (76 %), 69 (24 %) women] and were younger than women (78 vs 82 years, p < 0.001). A majority of patients were treated (212/283, 75 %), a similar proportion of women and men. Untreated patients had a higher mean age (84 vs 77 years, p < 0.001). The proportion treated with EVAR was 27 %, and they were older than OR treated (79 vs 76 years, p = 0.043). Forty-seven percentage of patients admitted with rAAA survived 30 days, and 62 % of treated patients survived 30 days. The 30-day mortality for women and men was similar.ConclusionsOur results and other contemporary series show a shift toward a higher rate of treated patients with rAAA, and improving outcomes, similar for women and men. The increased use of EVAR contributes to this improvement in short-term outcome. High age influences the willingness to treat patients with rAAA.

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Section: Discussionsupporting

confidence: 70%

“…Age has always been reported to be an influential factor when outcome is evaluated in surgical series [1, 22, 27, 31, 32]. It is clear that the number of aged patients is high among the untreated in this and other series.…”

Section: Discussionmentioning

confidence: 64%

A Majority of Admitted Patients With Ruptured Abdominal Aortic Aneurysm Undergo and Survive Corrective Treatment: A Population‐Based Retrospective Cohort Study

et al. 2016

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“…The treatment of a reasonably fit patient with an AAA is by open or endovascular aortic repair8. Intervention rates depend on several factors such as prevalence, diagnostic intensity in the community (for example organized or opportunistic screening) and access to vascular surgical units8, 9.…”

Section: Introductionmentioning

confidence: 99%

“…In several regions worldwide men are offered screening by ultrasonography, as long‐term follow‐up regarding the efficacy of screening programmes has shown an approximately 40 per cent reduction in AAA‐associated mortality5, 8, 10–12. An unexpectedly low incidence of AAA has been found in recent screening reports12, 13 in contrast to the reported increasing intervention rates for AAA in Europe9, 12, 14. A decrease in incidence and mortality from coronary heart disease (CHD) in Sweden (1986–2002) has been reported15, 16, and it is not known whether there is a similar trend for AAA.…”

Section: Introductionmentioning

confidence: 99%

Regional variation in the incidence of abdominal aortic aneurysm in Sweden

Hultgren

Forsberg

Alfredsson

et al. 2012

British Journal of Surgery

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“…Aortic aneurysms can develop in both the thoracic and abdominal aorta (Figure 1), albeit more patients suffer from and undergo surgery for aneurysms of the abdominal aorta [2,3]. Abdominal aortic aneurysms (AAAs) can be further categorized into supra-renal or para-visceral aneurysms if they involve the visceral arteries, para-renal if they involve the origins of the renal arteries or infra-renal if they begin lower than the renal arteries [4].…”

mentioning

confidence: 99%

Understanding the pathogenesis of abdominal aortic aneurysms

Kuivaniemi

Ryer

Elmore

et al. 2015

Expert Review of Cardiovascular Therapy

309

240

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Summary An aortic aneurysm is a dilatation in which the aortic diameter is ≥ 3.0 cm. If left untreated, the aortic wall continues to weaken and becomes unable to withstand the forces of the luminal blood pressure resulting in progressive dilatation and rupture, a catastrophic event associated with a mortality of 50 – 80%. Smoking and positive family history are important risk factors for the development of abdominal aortic aneurysms (AAA). Several genetic risk factors have also been identified. On the histological level, visible hallmarks of AAA pathogenesis include inflammation, smooth muscle cell apoptosis, extracellular matrix degradation, and oxidative stress. We expect that large genetic, genomic, epigenetic, proteomic and metabolomic studies will be undertaken by international consortia to identify additional risk factors and biomarkers, and to enhance our understanding of the pathobiology of AAA. Collaboration between different research groups will be important in overcoming the challenges to develop pharmacological treatments for AAA.

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More patients are treated for nonruptured abdominal aortic aneurysms, but the proportion of women remains unchanged

Cited by 25 publications

References 39 publications

A Majority of Admitted Patients With Ruptured Abdominal Aortic Aneurysm Undergo and Survive Corrective Treatment: A Population‐Based Retrospective Cohort Study

A Majority of Admitted Patients With Ruptured Abdominal Aortic Aneurysm Undergo and Survive Corrective Treatment: A Population‐Based Retrospective Cohort Study

Regional variation in the incidence of abdominal aortic aneurysm in Sweden

Understanding the pathogenesis of abdominal aortic aneurysms

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