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Outcomes in Men From the NHS Abdominal Aortic Aneurysm Screening Programme With a Large Aneurysm Referred for
Lewis Meecham1, Jo Jacomelli2, Meryl Davis3
1University Department of Vascular Surgery, Heart of England NHS Foundation Trust, UK.
Summary
Men referred for large abdominal aortic aneurysms had low turn-down rates but varied endovascular repair rates regionally. Procedures showed low peri-operative mortality, with EVAR having lower 30-day surgical mortality than open repair.
Area of Science:
- Vascular Surgery
- Public Health Screening
- Health Services Research
Background:
- The NHS Abdominal Aortic Aneurysm Screening Programme (NAAASP) screens men aged 65+ for large abdominal aortic aneurysms (AAAs) >54 mm.
- Referral for intervention is indicated for men with large AAAs detected during screening or surveillance.
Purpose of the Study:
- To analyze outcomes for men referred for intervention due to large AAAs.
- To investigate regional variations in AAA treatment rates and repair methods.
Main Methods:
- Analysis of data from the national NAAASP IT system (AAA SMaRT).
- Inclusion of all men referred to a vascular network with large AAAs.
- Extraction of demographic, assessment, and outcome data.
Main Results:
- 3,026 men were referred; 13.3% declined or were turned down for intervention.
- Turn-down rates were consistent across local programs.
- 2,624 men underwent AAA repair with 1.3% peri-operative mortality.
- Endovascular Aneurysm Repair (EVAR) had lower 30-day mortality (0.4%) than open repair (2.1%).
- Significant regional variation (20%-97%) in EVAR proportion.
Conclusions:
- Referral turn-down rates for screen-detected AAAs are low.
- Substantial regional disparities exist in endovascular repair rates.
- AAA repair procedures demonstrate low peri-operative mortality.
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