M A Sharp1, J Collin. 1. Nuffield Department of Surgery, University of Oxford, John Radcliffe Hospital, Headington, Oxford OX3 9DU, UK.
Abstract
OBJECTIVES: fast growth of abdominal aortic aneurysm (AAA) diameter is claimed to be an indication for repair. We investigated the validity of this claim. METHODS: between January 1988 and October 2000, 277 patients have had duplex sonography at six-monthly intervals in our aneurysm surveillance programme. During this period fast AAA growth was not an indication for operation in our unit. RESULTS: we identified 63 patients whose aneurysms had grown 0.5 cm or more in 6 months. Thirty-one of the 63 patients had aneurysms measuring 5.5 cm or greater in anterior-posterior diameter after the fast growth and all have been operated on unless deemed not fit due to anaesthetic risk. The remaining 32 patients continued in surveillance for a total of 50 patient years and none had rupture of their aneurysm. The calculated 95% confidence interval for the risk of rupture was 0-6 per 100 patient years. Six patients, who would have been operated on if fast growth had been an indication, have been spared surgery of whom 3 died and 3 became unfit. Nine patients remained in surveillance at the end of the study. CONCLUSION: our data support the view that rapid increase in AAA diameter is not an indication for elective AAA repair.
OBJECTIVES: fast growth of abdominal aortic aneurysm (AAA) diameter is claimed to be an indication for repair. We investigated the validity of this claim. METHODS: between January 1988 and October 2000, 277 patients have had duplex sonography at six-monthly intervals in our aneurysm surveillance programme. During this period fast AAA growth was not an indication for operation in our unit. RESULTS: we identified 63 patients whose aneurysms had grown 0.5 cm or more in 6 months. Thirty-one of the 63 patients had aneurysms measuring 5.5 cm or greater in anterior-posterior diameter after the fast growth and all have been operated on unless deemed not fit due to anaesthetic risk. The remaining 32 patients continued in surveillance for a total of 50 patient years and none had rupture of their aneurysm. The calculated 95% confidence interval for the risk of rupture was 0-6 per 100 patient years. Six patients, who would have been operated on if fast growth had been an indication, have been spared surgery of whom 3 died and 3 became unfit. Nine patients remained in surveillance at the end of the study. CONCLUSION: our data support the view that rapid increase in AAA diameter is not an indication for elective AAA repair.
Authors: Joseph V Moxon; Adam Parr; Theophilus I Emeto; Philip Walker; Paul E Norman; Jonathan Golledge Journal: Curr Probl Cardiol Date: 2010-10 Impact factor: 5.200
Authors: Ify R Mordi; Rachael O Forsythe; Corry Gellatly; Zaid Iskandar; Olivia M McBride; Athanasios Saratzis; Rod Chalmers; Calvin Chin; Matthew J Bown; David E Newby; Chim C Lang; Jeffrey T J Huang; Anna-Maria Choy Journal: J Am Heart Assoc Date: 2019-10-09 Impact factor: 5.501