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Abdominal aortic aneurysm--a plea for early elective excision (aneurysmectomy)
1Department of Surgery, Universiti Kebangsaan Malaysia, Kuala Lumpur.
The Medical Journal of Malaysia
|March 1, 1991
Summary
Abdominal aortic aneurysm (AAA) is a common arterial issue in Malaysia. Surgery for AAA is recommended for aneurysms 5cm or larger to prevent premature death, with elective surgery carrying a significantly lower risk than emergency procedures.
Area of Science:
- Vascular Surgery
- Public Health
- Epidemiology
Background:
- Abdominal aortic aneurysm (AAA) is the most frequent arterial problem in Malaysia, unlike peripheral arterial disease.
- The true incidence of AAA is likely underestimated due to undiagnosed or untreated cases.
Purpose of the Study:
- To prospectively study patients presenting with AAA in Malaysia.
- To analyze the demographics, presentation, and outcomes of AAA treatment.
- To provide recommendations for AAA management in the Malaysian context.
Main Methods:
- Prospective study of 100 consecutive AAA patients over 31 months (Jan 1986-Sep 1988).
- Patient demographics, AAA size (ultrasonography), and treatment outcomes (aneurysmectomy) were documented.
- Operative mortality for elective versus emergency surgery was compared.
Main Results:
- The study included 88 males and 12 females, aged 47-90 years (mean 68.7).
- AAA sizes ranged from 3-10 cm (mean 5.8 cm).
- Operative mortality was 2% for elective surgery and 47% for emergency surgery (ruptured AAA).
Conclusions:
- Elective surgery for AAA is significantly safer than emergency surgery.
- Patients with AAA of 5 cm or more should be advised surgery to avoid premature death.
- An estimated 17,000 individuals in Peninsular Malaysia may have AAA, highlighting a significant public health concern.