Clinical Characteristics and Treatment Results in the Patients with Abdominal Aortic Aneurysm.
- Author:
Jong Ho LEE
1
;
Ho Yong PARK
;
Young Wook KIM
Author Information
1. Department of Surgery, College of Medicine, Kyungpook National University Hospital, Korea. ywkim@kyungpook.ac.kr
- Publication Type:Original Article
- Keywords:
Abdominal aortic aneurysm;
Clinical feature;
Treatment
- MeSH:
Acute Kidney Injury;
Aneurysm;
Aorta;
Aortic Aneurysm, Abdominal*;
Arteries;
Coronary Artery Disease;
Embolism;
Female;
Flank Pain;
Gyeongsangbuk-do;
Hemorrhage;
Humans;
Hypertension;
Hypotension;
Ischemia;
Leg;
Lower Extremity;
Male;
Mass Screening;
Pancreas;
Pulmonary Disease, Chronic Obstructive;
Respiratory Insufficiency;
Retrospective Studies;
Rupture;
Sex Ratio;
Shock, Hemorrhagic;
Tomography, X-Ray Computed;
Transplants;
Ultrasonography;
Ureter
- From:Journal of the Korean Society for Vascular Surgery
1999;15(2):218-227
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The purposes of this study were to define the characteristics of the patients with AAA and to report the treatment results. METHOD: Eighty three patients (26 ruptured, 57 nonruptured AAA) with abdominal aortic aneurysms (AAAs) who were admitted to the Department of Surgery, Kyungpook National University Hospital were retrospectively reviewed for defining the clinical characteristics and treatment outcomes. RESULTS: Mean age of the patients was 68.8 years (range: 34~88 years) and male to female ratio was 3.2 to 1. In comparison between the groups with ruptured and nonruptured AAA, there were no significant differences in age, sex ratio, frequencies of coexistence of hypertension or chronic obstructive pulmonary disease. The mean aneurysm size was larger in ruptured AAA patients (6.8+/-2.2 cm vs 5.8+/-1.8 cm, p=0.043). Initial presenting symptoms were abdominal and/or flank pain in 31 (37.3%), hypotension or hemorrhagic shock in 11 (13.3%), and lower limb ischemia in 5 (6%) patients, while 32 (38.6%) patients presented with asymptomatic pulsatile abdominal mass and 4 (4.8%) patients were incidentally detected without palpable mass or subjective symptoms. Of the 31 patients presented with pain, only 15 patients (48.4%) were confirmed to have aneurysmal rupture via surgery or CT scanning. Coexisting morbidities were hypertension (43.4%), chronic obstructive pulmonary disease (15.7%), coronary artery disease (9.6%), cerebrovascular disease (9.6%), diabetes (4.8%) and chronic leg artery occlusive disease (4.8%). Surgical treatment was performed in 62 patients (21 ruptured AAAs, 41 nonruptured AAAs). The locations of the AAAs were suprarenal in 3 (4.8%), juxtarenal in 4 (6.5%), and infrarenal aorta in 55 (88.7%) patients. All aneurysms were fusiform in their shape except one saccular form. There were 2 (3.8%) patients with inflammatory aneursysm. Surgical complications following 62 AAA repairs included respiratory failure in 5 (8.1%), acute renal failure in 2 (3.2%), and 2 arterial embolisms, 1 retroperitoneal bleeding, 1 graft infection, 1 ureter injury and 1 pancreas injury. Four (19%) deaths occured in the ruptured AAA patients but none in the nonruptured AAA patients group. CONCLUSION: After experiencing a high frequency of symptomatic AAA patients, we can assume that there lies a vast hidden population of asymptomatic AAAs in our society. Furthermore, the favorable results achieved in the nonruptured AAA repairs, it is our suggestion that a routine ultrasound examination of the aorta be included in the health screening program for old people to detect these asymptomatic AAA patients.
