Skip to main content
Annals of Surgery logoLink to Annals of Surgery
. 1975 Jun;181(6):863–869. doi: 10.1097/00000658-197506000-00019

Survival improvement following aortic aneurysm resection.

G L Hicks, M W Eastland, J A DeWeese, A G May, C G Rob
PMCID: PMC1343910  PMID: 1138637

Abstract

Abdominal aortic aneurysm resections were performed on 298 patients between January, 1966 and December, 1973. The results were compared with 186 resections previously reported between 1955-1965. Hospital mortality rates for elective resections were 13% in 1955-1965, 8.4% in 1966-1973, and 4.2% in the 113 patients treated during the last 3 years. Urgent resections for intact aneurysms, previously associated with a 36% mortality, resulted in a 6% mortality rate in 1966-1973. The emergency resection mortality rate for ruptured aneurysm, originally 69%, was reduced to a present day over-all mortality of 55%, and 42% for the last 3 years. Calculated actuarial survival at 5 years was 65% for urgent (intact), 60% for elective and 40% for emergency (ruptured) groups. Atherosclerosis remains the major deterrent to long-term survival with myocardial infarction and stroke causing 43% of deaths occurring within 5 years. Improved survival appeared secondary to better operative technique, postoperative patient monitoring, increased surgical experience, and more elective resections of smaller, asymptomatic aneurysms than in 1955-1965. With present day low mortality rates, elective resection should be recommended in all patients without significant medical contraindications.

Full text

PDF
866

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alpert J., Brief D. K., Parsonnet V. Surgery for the ruptured abdominal aortic aneurysm. JAMA. 1970 May 25;212(8):1355–1359. [PubMed] [Google Scholar]
  2. Baker A. G., Jr, Roberts B. Long-term survival following abdominal aortic aneurysmectomy. JAMA. 1970 Apr 20;212(3):445–450. [PubMed] [Google Scholar]
  3. Bernstein E. F., Fisher J. C., Varco R. L. Is excision the optimum treatment for all abdominal aortic aneurysms? Surgery. 1967 Jan;61(1):83–93. [PubMed] [Google Scholar]
  4. CANNON J. A., VANDEWATER J., BARKER W. F. EXPERIENCE WITH THE SURGICAL MANAGEMENT OF 100 CONSECUTIVE CASES OF ABDOMINAL AORTIC ANEURYSM. Am J Surg. 1963 Aug;106:128–143. doi: 10.1016/0002-9610(63)90003-5. [DOI] [PubMed] [Google Scholar]
  5. Couch N. P., Lane F. C., Crane C. Management and mortality in resection of abdominal aortic aneurysms. A study of 114 cases. Am J Surg. 1970 Apr;119(4):408–416. doi: 10.1016/0002-9610(70)90142-x. [DOI] [PubMed] [Google Scholar]
  6. DUBOST C., ALLARY M., OECONOMOS N. Resection of an aneurysm of the abdominal aorta: reestablishment of the continuity by a preserved human arterial graft, with result after five months. AMA Arch Surg. 1952 Mar;64(3):405–408. [PubMed] [Google Scholar]
  7. DeWeese J. A., Blaisdell F. W., Foster J. H. Optimal resources for vascular surgery. Arch Surg. 1972 Dec;105(6):948–961. doi: 10.1001/archsurg.1972.04180120123022. [DOI] [PubMed] [Google Scholar]
  8. DeWeese J. A., Rob C. G. Autogenous venous bypass grafts five years later. Ann Surg. 1971 Sep;174(3):346–356. doi: 10.1097/00000658-197109000-00003. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. DeWeese J. A., Rob C. G., Satran R., Marsh D. O., Joynt R. J., Summers D., Nichols C. Results of carotid endarterectomies for transient ischemic attacks-five years later. Ann Surg. 1973 Sep;178(3):258–264. doi: 10.1097/00000658-197309000-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Dodenhoff T., Cox E. F. The acutely symptomatic aneurysm; a surgical emergency. Am Surg. 1969 Oct;35(10):691–694. [PubMed] [Google Scholar]
  11. ESTES J. E., Jr Abdominal aortic aneurysm; a study of one hundred and two cases. Circulation. 1950 Aug;2(2):258–264. doi: 10.1161/01.cir.2.2.258. [DOI] [PubMed] [Google Scholar]
  12. Foster J. H., Bolasny B. L., Gobbel W. G., Jr, Scott H. W., Jr Comparative study of elective resection and expectant treatment of abdomianl aortic aneurysm. Surg Gynecol Obstet. 1969 Jul;129(1):1–9. [PubMed] [Google Scholar]
  13. Friedman S. A., Hufnagel C. A., Conrad P. W., Simmons E. M., Weintraub A. Abdominal aortic aneurysms. Clinical status and results of surgery in 100 consecutive cases. JAMA. 1967 Jun 26;200(13):1147–1151. doi: 10.1001/jama.200.13.1147. [DOI] [PubMed] [Google Scholar]
  14. GRYSKA P. F., WHEELER C. G., LINTON R. R. A review of seven years' experience with excision and graft replacement in 150 ruputured and unruptured aneurysms of the abdominal aorta. N Engl J Med. 1961 Mar 30;264:639–641. doi: 10.1056/NEJM196103302641303. [DOI] [PubMed] [Google Scholar]
  15. Gardner R. J., Lancaster J. R., Tarnay T. J., Warden H. E., Currie R. A. Five year history of surgically treated abdominal aortic aneurysms. Surg Gynecol Obstet. 1970 Jun;130(6):981–987. [PubMed] [Google Scholar]
  16. HARDIN C. A. SURVIVAL AND COMPLICATIONS AFTER 121 SURGICALLY TREATED ABDOMINAL ANEURYSMS. Surg Gynecol Obstet. 1964 Mar;118:541–544. [PubMed] [Google Scholar]
  17. Key J. A., Sokol D. M. The symptomless abdominal aneurysm--a 15-year review. Can J Surg. 1973 Jul;16(4):297–300. [PubMed] [Google Scholar]
  18. Kouchoukos N. T., Levy J. F., Butcher H. R., Jr Mortality from ruptured abdominal aortic aneurysm. Am J Surg. 1967 Feb;113(2):232–235. doi: 10.1016/0002-9610(67)90229-2. [DOI] [PubMed] [Google Scholar]
  19. Levy J. F., Kouchoukos N. T., Walker W. B., Butcher H. R., Jr Abdominal aortic aneurysmectomy. A study of 100 cases. Arch Surg. 1966 Apr;92(4):498–503. doi: 10.1001/archsurg.1966.01320220054008. [DOI] [PubMed] [Google Scholar]
  20. MANNICK J. A., BROOKS J. W., BOSHER L. H., Jr, HUME D. M. RUPTURED ANEURYSMS OF THE ABDOMINAL AORTA; A REAPPRAISAL. N Engl J Med. 1964 Oct 29;271:915–920. doi: 10.1056/NEJM196410292711801. [DOI] [PubMed] [Google Scholar]
  21. May A. G., DeWeese J. A., Frank I., Mahoney E. B., Rob C. G. Surgical treatment of abdominal aortic aneurysms. Surgery. 1968 May;63(5):711–721. [PubMed] [Google Scholar]
  22. Rainer W. G., Sadler T. R., Jr, Guillen J. Ruptured abdominal aortic aneurysm. Logistical and surgical considerations. Am J Surg. 1973 Dec;126(6):794–797. doi: 10.1016/s0002-9610(73)80073-x. [DOI] [PubMed] [Google Scholar]
  23. SCHATZ I. J., FAIRBAIRN J. F., 2nd, JUERGENS J. L. Abdominal aortic aneurysms. A reappraisal. Circulation. 1962 Aug;26:200–205. doi: 10.1161/01.cir.26.2.200. [DOI] [PubMed] [Google Scholar]
  24. Stokes J., Butcher H. R., Jr Abdominal aortic aneurysms. Factors influencing operative mortality and criteria of operability. Arch Surg. 1973 Aug;107(2):297–302. doi: 10.1001/archsurg.1973.01350200157033. [DOI] [PubMed] [Google Scholar]
  25. Szilagyi D. E., Elliott J. P., Smith R. F. Clinical fate of the patient with asymptomatic abdominal aortic aneurysm and unfit for surgical treatment. Arch Surg. 1972 Apr;104(4):600–606. doi: 10.1001/archsurg.1972.04180040214036. [DOI] [PubMed] [Google Scholar]
  26. Szilagyi D. E., Smith R. F., DeRusso F. J., Elliott J. P., Sherrin F. W. Contribution of abdominal aortic aneurysmectomy to prolongation of life. Ann Surg. 1966 Oct;164(4):678–699. doi: 10.1097/00000658-196610000-00014. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. VASKO J. S., SPENCER F. C., BAHNSON H. T. Aneurysm of the aorta treated by excision. Review of 237 cases followed up to seven years. Am J Surg. 1963 Jun;105:793–801. doi: 10.1016/0002-9610(63)90494-x. [DOI] [PubMed] [Google Scholar]
  28. VOORHEES A. B., Jr, MCALLISTER F. F. LONG TERM RESULTS FOLLOWING RESECTION OF ARTERIOSCLEROTIC ABDOMINAL AORTIC ANEURYSMS. Surg Gynecol Obstet. 1963 Sep;117:355–358. [PubMed] [Google Scholar]
  29. Van Heeckeren D. W. Ruptured abdominal aortic aneurysms. Am J Surg. 1970 Apr;119(4):402–407. doi: 10.1016/0002-9610(70)90141-8. [DOI] [PubMed] [Google Scholar]
  30. Williams R. D., Fisher F. W., Dickey J. W., Jr Problems in the diagnosis and treatment of abdominal aortic aneurysms. Am J Surg. 1972 Jun;123(6):698–701. doi: 10.1016/0002-9610(72)90357-1. [DOI] [PubMed] [Google Scholar]
  31. Wolffe J. B., Colcher R. E. Diagnosis and conservative management of atherosclerotic aneurysms of the abdominal aorta. Vasc Dis. 1966 Feb;3(1):49–57. [PubMed] [Google Scholar]
  32. Yashar J. J., Indeglia R. A., Yashar J. Surgery for abdominal aortic aneurysms. Factors affecting survival and long-term results. Am J Surg. 1972 Apr;123(4):398–405. doi: 10.1016/0002-9610(72)90190-0. [DOI] [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES