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[Aneurysms of the subrenal abdominal aorta. Apropos of 115 cases]
Insights
This study on infrarenal abdominal aortic aneurysms found that surgery for ruptured aneurysms had a high mortality rate (77.4%) compared to non-ruptured ones (2.63%). Lower limb ischemia remains a key diagnostic symptom.
Area of Science:
- Vascular Surgery
- Aortic Aneurysm Research
- Clinical Outcomes Analysis
Context:
- Analysis of 115 infrarenal abdominal aortic aneurysm surgeries performed between 1969 and 1984.
- Patient demographics included 93% males with an average age of 65.5.
- High prevalence of risk factors such as hypertension (43%), smoking (74%), and coronary disease (20.5%) noted.
Purpose:
- To evaluate surgical outcomes and long-term survival for infrarenal abdominal aortic aneurysms.
- To assess the diagnostic significance of lower limb ischemia in aneurysm presentation.
- To compare mortality rates between ruptured and non-ruptured aneurysm surgeries.
Summary:
- 84 (73%) non-ruptured and 31 (27%) ruptured aneurysms were operated on.
- Resection and grafting for non-ruptured aneurysms had a low mortality (2.63%), while ruptured aneurysms had a high mortality (77.4%).
- Five-year survival for operated patients was 62.7%; lower limb ischemia frequently indicated aneurysm presence.
Impact:
- Highlights the critical difference in outcomes between ruptured and non-ruptured aortic aneurysms.
- Emphasizes the continued importance of recognizing lower limb ischemia as a potential sign of abdominal aortic aneurysms.
- Provides historical data on surgical management and outcomes in vascular surgery.
Abstract:
115 of infra renal abdominal aorta have been operated upon between 1969 and 1984. 107 male patients (93%) and 8 female (7%) were treated. Age was 65.5. Associated high blood pressure was found in 43%, smoking in 74% and coronary disease in 20.5%. Non ruptured aneurysms were 84 (73%) and diagnosis was made chiefly in ischemia of lower limbs, ruptured were 31 (27%). 4 fistulas between aorta and lower vena cava were found at surgery. Aortograms have not been done in every case, even for non ruptured aneurysms, as 19 patients have been operated without (22.6% of non ruptured aneurysms). Ultrasonography have been done in 37. Among 84 patients with non ruptured aneurysm, 6 were not operated, 2 got only palliative surgery for rest pain, and 76 (85.7%) underwent resection and grafting. 31 patients were operated when ruptured. Post operative mortality for non ruptured aneurysms was of 2 (2.63%) for resection and grafting. It was of 24 (77.4%) if ruptured. Follow-up study shows that at a five years range 62.7% of surviving operated patients are alive. Authors point out that lower limbs ischemia is still often a revealing symptom. Post operative colic ischemia is rare.