Summary
Since abdominal ultrasonography has become a routine diagnostic procedure, increasing numbers of small asymptomatic abdominal aortic aneurysms are detected incidentally. Of 128 patients (108 male, 20 female) with abdominal aortic aneurysms, 96 patients were observed clinically and by repeated ultrasound studies for an average of 3.47 years, adding up to a total observation period of 333 patient-years. Among these 96 patients, 72 had small aneurysms (averaged diameters less than 5 cm). Three of them were lost to follow up. None of the remaining 69 patients died from rupture, 20 died from other causes and 8 patients were successfully operated. Of the patients with a large aneurysm one was lost to follow up. Five patients of the remaining 23 died as a result of rupture, 7 were successfully operated. The average growth rate of small aneurysms was 0.18 cm/year, whereas the larger aneurysms showed a growth rate of 0.28 cm/year (diameter).
The survival rate of patients with small aneurysms was 94% after one year, 80% after 3 years, and 73 % after 5 years, indicating that life expectancy is reduced in patients with an aneurysm of the abdominal aorta, but not because of complications of the aneurysm.
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Allardice JT, Allwright GJ, Wafula JM, Wyatt AP (1988) High prevalence of abdominal aortic aneurysm in men with peripheral vascular disease: screening by ultrasonography. Br J Surg 75:240–242
Auerbach O, Garfinkel L (1980) Atherosclerosis and aneurysm of aorta in relation to smoking habits and age. Chest 78:805–809
Baker WH, Munns R (1975) Aneurysmectomy in the aged. Arch Surg 110:513–517
Bardram L, Buchardt Hansen HJ, Dahl Hansen AB (1980) Abdominal aortic aneurysms: early and late results after surgical and nonsurgical treatment. Acta Chir Scand 502:85–93
Becker HM, Kortmann H (1983) Zur chirurgischen Behandlung des infrarenalen Bauchaortenaneurysmas — Standort-bestimmung und Perspektiven. Angiology 5:191–198
Becker HM, Stelter WJ (1983) Bauchaortenaneurysma — Ergebnisse der chirurgischen Therapie. Fortschr Med 101:1568–1571
Bernstein EF, Chan EL (1984) Abdominal aortic aneurysm in high-risk patients. Ann Surg 200:255–264
Bernstein EF, Dilley RB, Goldberger LE, Gosink BB, Leopold RR (1976) Growth rates of small abdominal aortic aneurysms. Surgery 80:765–773
Bickerstaff LK, Hollier LH, van Peenen HJ, Melton III LJ, Pairolero PC, Cherry KJ (1984) Abdominal aortic aneurysms: the changing natural history. J Vasc Surg 1:6–12
Brewster DC, Darling RC, Raines JK, Sarno R, O'Donnell TF, Ezpeleta M, Athanasoulis C (1977) Assessment of abdominal aortic aneurysm size. Circulation 56:164–169
Brown OW, Hollier LH, Pairolero PC, Kazmier FJ, Mc Ready RA (1981) Abdominal aortic aneurysm and coronary artery disease — a reassessment. Arch Surg 116:1484–1488
Carlsson J, Sternby NH (1964) Aortic aneurysms. Acta Chir Scand 127:466–473
Chan EL, Leopold GR, Bernstein EF (1985) Abdominal aortic aneurysm expansion. San Diego Symposium on noninvasive diagnostic techniques in vascular disease
Christenson J, Eklöf B, Gustafson I (1977) Abdominal aortic aneurysms: should they all be resected? Br J Surg 64:767–772
Collin J (1988) The epidemiology of abdominal aortic aneurysm. Br J Hosp Med 40:64–67
Collin J, Araujo L, Walton J, Lindsell D (1988) Oxford screening programme for abdominal aortic aneurysm in men aged 65 to 74 years. Lancet 2:613–615
Cooley DA, Carmichael MJ (1984) Abdominal aortic aneurysm. Circulation 70 [Suppl I]:I 5–6
Crane C (1955) Arteriosclerotic aneurysm of the abdominal aorta — some pathological and clinical correlations. N Engl J Med 253:954–958
Darling RC, Brewster DC (1980) Elective treatment of abdominal aortic aneurysms. World J Surg 4:661–667
Darling RC, Messina CR, Brewster DC, Ottinger LW (1976) Autopsy study of unoperated abdominal aortic aneurysms. Cardiovasc Surg 56:161–164
De Bakey ME, Crawford ES, Cooley DA (1984) Aneurysm of abdominal aorta. Ann Surg 160:622–638
Egloff L, Dimai W, Schneider E, Kugelmeier J, Turina M, Senning A (1983) Das Bauchaortenaneurysma beim über 70jährigen Patienten — soll es in jedem Fall operiert werden? Schweiz Med Wochenschr 113:208–211
Esselstyn CB, Humphries AW, Young JR, Beven EG, de Wolfe VG (1970) Aneurysmectomy in the aged? Surgery 67:34–39
Estes JE (1950) Abdominal aortic aneurysm. A study of 102 cases. Circulation 2:258–264
Fielding L, Black J, Ashton F, Slaney G, Cambell DJ (1981) Diagnosis and management of 528 abdominal aortic aneurysms. Br Med J 283:355–359
Foster JH, Bolasny BL, Gobbel WG, Scott HW (1969) Comparative study of elective resection and expectant treatment of abdominal aortic aneurysms. Surg Gynecol Obstet 129:1–9
Fowkes FGR, MacIntyre CCA, Ruckley CV (1989) Increasing incidence of aortic aneurysms in England and Wales. Br Med J 298:33–35
Gowland Hopkins NF (1987) Abdominal aortic aneurysms. Br Med J 294:790–791
Graham M, Chan A (1988) Ultrasound screening for clinically occult abdominal aortic aneurysm. Can Med Assoc J 138:627–629
Hammond EC, Garfinkel L (1969) Coronary heart disease, stroke and aortic aneurysm: factors in the etiology. Arch Environ Health 19:167–182
Haschka C (1987) Wachstumskurven von Bauchaortenaneurysmen. Inaugural-Dissertation, Universität München
Hepp W, Krier S (1981) Das abdominale Aortenaneurysma — Früh- und Spätergebnisse bei 131 operierten Patienten (1970–1978). Angiology 3:75–80
Hertzer NR, Young JR, Kramer JR, Phillips DF, de Wolfe VG, Ruschhaupt WF, Beven EG (1979) Routine coronary angiography prior to elective aortic reconstruction: results of selective myocardial revascularization in patients with peripheral vascular disease. Arch Surg 114:1336–1344
Johansen K, Koepsell T (1986) Familial tendency for abdominal aortic aneurysms. JAMA 256:1934–1936
Kahn HA (1966) The Dorn study of smoking and mortality among U.S. veterans: report on 81/2 years of observation. Natl Cancer Inst Monogr 19:1–125
Kessler E, Gaylis H (1981) Nonruptured aortic aneurysms. Surg Gynecol Obstet 152:781–783
Kortmann H, Becker HM (1982) Zur Chirurgie des Bauchaortenaneurysmas beim alten Menschen. In: Heberer G, Witte J (Hrsg) Chirurgie im hohen Alter — perioperative Aspekte. Perimed, Erlangen, S 70–71
Kortmann H, Becker HM (1985) Bauchaortenaneurysmen; diagnostische und chirurgische Probleme im höheren Alter. Z Gerontol 18:44–47
Kortmann H, Capeller WA, Becker HM (1986) Das infrarenale Bauchaortenaneurysma beim alten Menschen — Operationsrisiko vs. Rupturgefahr. Langenbecks Arch Chir 369:339–343
Kremer H, Weigold B, Dobrinski W, Schreiber MA, Zöllner N (1984) Sonographische Verlaufsbeobachtungen von Bauchchaortenaneurysmen. Klin Wochenschr 62:1120–1125
Leach SD, Toole AL, Stern H, DeNatale RW, Tilson MD (1988) Effect of beta-adrenergic blockade on the growth rate of abdominal aortic aneurysms. Arch Surg 123:606–609
Lederle FA, Walker JM, Reinke DB (1988) Selective screening for abdominal aortic aneurysms with physical examination and ultrasound. Arch Intern Med 148:1753–1756
Lee ET (1980) Statistical methods for survival data analysis. Lifetime Learning, Belmont
Liljeqvist L, Ekeström S, Nordhus O (1979) Abdominal aortic aneurysms: II. Long-term follow-up of operated and unoperated patients. Acta Chir Scand 145:529–533
Mc Cabe CJ, Coleman WS, Brewster DC (1981) The advantage of early operation for abdominal aortic aneurysm. Arch Surg 116:1025–1029
Nevitt NP, Ballard DJ, Hallett Jr JW (1989) Prognosis of abdominal aortic aneurisms. A population based study. N Engl J Med 321:1009–1114
Noyez L, Nevelsteen A, Suy R, Daenen W, Stalpaert G (1987) Abdominale aneurysmata: resultaten op lange termijn. Acta Chir Belg 87:69–72
O'Donnell TF, Darling RC, Linton RR (1976) Is 80 years too old for aneurysmectomy? Arch Surg 111:1250–1256
O'Kelly TJ, Heather BP (1988) The feasibility of screening for abdominal aortic aneurysms in a district general hospital. Ann R Coll Surg Engl 70:197–199
Pasch AR, Ricotta JJ, Allyn GM, Green RM, de Weese JE (1984) Abdominal aortic aneurysm: the case for elective resection. Circulation 70 [Suppl I]:1–4
Postier R, Browne HJ, Lynch G, Johnston J, Hyland J (1982) The treatment of aortic aneurysms: the results in 436 consecutive patients. Ir Med J 75:279–287
Rantakokko V, Havia T, Inberg MV, Vänttinen E (1983) Abdominal aortic aneurysms: a clinical and autopsy study of 408 patients. Acta Chir Scand 149:151–155
Roberts WC (1975) The hypertensive disease. Evidence that systemic hypertension is a greater risk factor to the development of other cardiovascular diseases than previously suspected. Am J Med 59:523–532
Ruckert RF, Meier WE, Senning A (1981) Das infrarenale Bauchaortenaneurysma. Schweiz Med Wochenschr 111:1274–1282
Rutherford RB (1984) Infrarenal aortic aneurysms. In: Rutherford RB (ed) Vascular surgery, 2nd edn. WB Saunders, Philadelphia pp 755–771
Schatz IJ, Fairbairn JF, Juergens JL (1962) Abdominal aortic aneurysms — a reappraisal. Circulation 26:200–205
Scobie K, Mc Phail N, Hubbard C (1977) Early and late results of resection of abdominal aortic aneurysms. Can Med Assoc J 117:147–150
Søreide O, Grimsgaard C, Myhre HO, Solheim K, Trippestad A (1982) Time and cause of death for 301 patients operated on for abdominal aortic aneurysms. Age Ageing 11:256–260
Spittell JA (1983) Hypertension and arterial aneurysms. J Am Coll Cardiol 1 (2):533–540
Sterpetti AV, Schultz RD, Feldhaus RJ, Peetz DJ, Fasciano AJ, Mc Gill JE (1985) Abdominal aortic aneurysm in elderly patients. Am J Surg 150:772–776
Szilagyi DE, Elliott JP, Smith RF (1972) Clinical fate of the patient with asymptomatic abdominal aortic aneurysm and unfit for surgical treatment. Arch Surg 104:600–606
Szilagyi DE, Smith RF, Derusso R (1966) Contribution of abdominal aortic aneurysmectomy to prolongation of life. Ann Surg 164:678–699
Twomey A, Twomey E, Wilkins RA, Lewis JD (1986) Unrecognized aneurysmal disease in male hypertensive patients. Int Angiol 5:269–273
Vollmar JF, Paes E (1986) Operationsindikation beim Aortenaneurysma im hohen Lebensalter. Langenbecks Arch Chir 369:327–332
Walker EM, Hopkinson BR, Makin GS (1983) Unoperated abdominal aortic aneurysms. Presentation and natural history. Ann R Coll Surg Engl 65:311–313
Weigold B, Zoller WG, Spengel F, Zöllner N (1989) Überlebenswahrscheinlichkeit von Patienten mit zufällig entdeckten Bauchaortenaneurysmen. Klin Wochenschr 67:92
Whitemore AD, Clowes AW, Hechtmann HB, Mannick JA (1980) Aortic aneurysms repair — reduced operative mortality associated with maintenance of optimal cardiac performance. Ann Surg 192:414–421
Wolffe JB, Colcher RE (1966) Diagnosis and conservative management of atherosclerotic aneurysms of the abdominal aorta. Vasc Dis 3:49–57
Young AE, Sandberg GW, Couch NP (1977) The reduction of mortality of abdominal aortic aneurysm resection. Am J Surg 134:585–590
Zoller WG, Stapff M, Weigold B, Spengel FA, Zöllner N (1988) Duplexsonographische Untersuchungen bei Bauchaortenaneurysmen (BAA). Ultraschall Klin Prax 1:58–59
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Zöllner, N., Zoller, W.G., Spengel, F. et al. The spontaneous course of small abdominal aortic aneurysms. Aneurysmal growth rates and life expectancy. Klin Wochenschr 69, 633–639 (1991). https://doi.org/10.1007/BF01649423
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DOI: https://doi.org/10.1007/BF01649423