H. Bengtsson et al., EXPANSION PATTERN AND RISK OF RUPTURE OF ABDOMINAL AORTIC-ANEURYSMS THAT WERE NOT OPERATED ON, The European journal of surgery, 159(9), 1993, pp. 461-467
Objective: To analyse the outcome of selective management of patients
with abdominal aortic aneurysms, the expansion patterns of the aneurys
ms, and the factors that influenced the rate of rupture. Design: Retro
spective study. Setting: Malmo General Hospital, Lund University, Malm
o, Sweden. Subjects: 155 patients (96 men and 59 women) with abdominal
aortic aneurysms who were not selected for operation for whatever rea
son were included in the study immediately after their first ultrasoun
d scan. Main outcome measures: Mortality, expansion rate (mm/year) mea
sured on ultrasound scan. and rate of rupture of aneurysm. Results: Me
dian aneurysmal diameter was 40 mm (range 20-80), and length (n = 106)
70 (range 28-140). The patients were followed up for a median of 3.4
years (range 0-10.2). A total of 107 patients died and in 21 the aneur
ysms ruptured (4 were operated on and survived). Thirteen patients wer
e re-evaluated and operated on electively. Ultrasonography was repeate
d in 98 patients, the median expansion rates (mm/year) were 3.1 (diame
ter) and 1.9 (length). There was a significant linear relationship bet
ween initial size (diameter and length) and rate of expansion of diame
ter. The risk of rupture was greater in larger aneurysms that were exp
anding more quickly. The cumulative mortality was not affected by the
21 aneurysms that ruptured. Conclusion: Selective management of patien
ts with aortic aneurysms is justified.