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INTERNATIONAL ANGIOLOGY

Rivista di Angiologia


Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
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International Angiology 1998 December;17(4):234-40

Copyright © 2000 EDIZIONI MINERVA MEDICA

lingua: Inglese

Ten-year results following elective surgery for abdominal aortic aneurysm

Cappeller W.-A., Holzel D., Hinz M. H., Lauterjung L.

From the Department of Surgery and Institute for Medical Informatik, * Biometrie and Epidemiology, Klinikum Grosshadern, Ludwig-Maximilians-Universität München, Germany


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Objective. 10-year results after elec­tive oper­a­tion for infra­ren­al aor­tic aneu­rysm con­sid­er­ing the influ­ence of risk fac­tors.
Experimental ­design. Retrospective study with 5-12 year post­op­er­a­tive fol­low-up.
Setting. University hos­pi­tal (Klinikum Grosshadern, Mu-nich).
Patients. The long-term fol­low-up was based on 521 (95.6%) out of 545 con­sec­u­tive ­patients oper­at­ed upon elec­tive­ly for abdom­i­nal aor­tic aneu­rysm ­between 1978 and 1987.
Interventions. The infra­ren­al aneu­rysms were exclud­ed by aor­tic tube ­grafts (314 ­patients, 59%) or bifur­ca­tion ­grafts (231 ­patients, 41%).
Measures. The birth­day, oper­a­tion day and even­tu­al­ly the day of death in the hos­pi­tal were doc­u­ment­ed in the ­charts. The ­patient`s state or cause of death were elicited on the phone 5 to 12 years after the oper­a­tion. Kaplan-Meier sur­vi­val ­curves were cal­cu­lat­ed based on these data and com­pared to age-­matched nor­mal male pop­u­la­tions.
Results. Hospital mor­tal­ity was 6.4%. The cumu­la­tive rate of sur­vi­val fol­low­ing elec­tive sur­gery was 65% at 5 years and 41% at 10 years, the mean sur­vi­val time being 95.1 ­months. Age, cor­o­nary ­artery dis­ease and hyper­ten­sion had a sig­nif­i­cant influ­ence on the cumu­la­tive sur­vi­val. Patients with aorto-cor­o­nary ­bypass had a bet­ter long-term out­come than those with­out ­bypass sur­gery.
Conclusions. The excel­lent long-term ­results with­in a high-risk pop­u­la­tion sup­port elec­tive sur­gery of infra­ren­al aor­tic aneu­rysms. Results of new inter­ven­tio­nal tech­niques will have to be com­pared with this “gold­en stan­dard” fol­low-up.

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