Operation for aneurysm yields nearly normal longevity

08 july 2009--Preventive operations are being used more and more often to treat abdominal aortic aneurysms. Even though the operation is now being offered to ever older and sicker patients, the long-term survival of those who have had the operation has improved over the last two decades. This is shown in a major Swedish study in which researchers from Uppsala University examined 12,000 patients. The findings are published in Circulation: Journal of the American Heart Association.

Each year between 700 and 1,000 Swedes die as a result of rupture of abdominal aortic aneurysms. The number of preventive operations is on the rise throughout the Western world, for one thing because the population is growing older and also because with new methods it is possible today to treat older and sicker patients. How patients' long-term survival following the operation has been affected by the fact that older and sicker patients are being operated on has been unclear until now. Long-term survival is not only of great importance to the patient, but also to society, since the operation is a major and costly intervention.

The research team has previously reported that fewer and fewer patients are dying in connection with the operation. In the new study, which is based on the Swedish vascular registry (Swedvasc), the researchers have studied the long-term survival of more than 12,000 patients who underwent operations for abdominal aortic aneurysm in Sweden between 1987 and 2005.

The study shows that on average patients live nine years after the operation, which is only marginally shorter than the normal longevity of Swedes of the same age and sex. Men and patients over the age of 80 had better so-called relative survival than women and patients under 80. The fact that the women did not live as long as the men following the operation is believed be due to the circumstance that women with aortic aneurysm often also have more pronounced atherosclerosis.

"Patients who undergo operations for abdominal aortic aneurysm can look forward to nearly normal longevity," says Kevin Mani, a researcher at the Division of Vascular Surgery at Uppsala University and physician at Uppsala University Hospital. He is the lead author of the study.

"Patients are being treated more and more effectively after the operation, which has improved both the short- and long-term results. This is also good news in terms of the cost of health care: the longer patients survive after the intervention, the more cost-effective the operations are," says Kevin Mani.