Study suggests elective surgical repair is safe intervention for abdominal aortic aneurysm

Research from the Society for Vascular Surgery® in collaboration with the Mount Sinai School of Medicine Department of Health Evidence and Policy in New York City evaluated the data of 3.1 million patients who were at risk for an abdominal aortic aneurysm (AAA). Their work as a data coordinating center for this project was funded by a grant to the SVS from Life Line Screening, Independence, Ohio. Results have been published in the September issue of SVS' Journal of Vascular Surgery®.

"During our research we determined that approximately half of the patients having AAA disease are not eligible for screening under current guidelines, so we created a high-yield screening algorithm that expands the target population," said Craig Kent, MD, a vascular surgeon and Chair of Surgery at University of Wisconsin.

This predictive scoring system also identified aneurysms more efficiently, added Dr. Kent. Data was collected from more than 20,000 screening sites across the nation from patients who had completed a medical and lifestyle questionnaire and were evaluated by ultrasound for the presence of AAA by Life Line Screening. Risk factors associated with AAA were then identified using multivariable logistic regression analysis.

"Our researchers reaffirmed well-known risk factors for AAA, including male gender, age, family history, and cardiovascular disease," said Dr. Kent. "However, our algorithm expands the data to included females, non-smokers and individuals 65 years and younger. Using this current model on national statistics of risk factors prevalence, we estimated that there are 1.1 million AAAs in the United States, of which 569,000 are among the women, patients that did not smoke and persons age 65 or younger."

The study also showed that smoking cessation and a healthy lifestyle are associated with lower risk of AAA. Researchers also observed an increased rate of AAA with increasing years of smoking and the number of cigarettes smoked. There was a reduction in the risk of AAA with smoking cessation.

Excess weight was associated with increased risk, whereas exercise and consumption of nuts, vegetables, and fruits were associated with reduced risk. Blacks, Hispanics and Asians had lower risk of having AAA than Whites and Native Americans.

"Abdominal aortic aneurysm is an insidious condition with an 85percent chance of death following rupture," said Dr. Kent. "Screening using noninvasive ultrasound can save lives but its use is advocated only for a limited subset of the population at risk. Patients who are not in an emergency situation prior to a rupture, have an option to undergo elective surgical repair or their aneurysms which is a safe an effective intervention."