A Clinical Consideration of Abdominal Aortic Aneurysm Rupture

Lim, Seung Taek; Kim, Young Kyun; Hwang, Jeong Kye; Kim, Sang Dong; Park, Sun Chul; Won, Yong Sung; Park, Jang Sang; Kim, Ji Il; Yun, Sang Seob; Moon, In Sung

Abstract

PURPOSE
With current advances in surgical technique, the prognosis for elective open repair of abdominal aortic aneurysm (AAA) has improved, but the mortality rate for ruptured AAA remains high. The aim of this study was to define the risk factors of AAA rupture.
METHODS
We performed a retrospective analysis of 169 AAA patients who underwent open surgical repair between March 2000 and October 2010. According to the rupture, the patients were divided into 2 groups: 'ruptured' (n=41), 'non-ruptured' (n=128). To define the risk factor of ruptured AAA, we compared following variables between the 2 groups: clinical co-morbidities (hypertension, diabetes mellitus, ischemic heart disease, malignancies), diameter (maximal diameter of AAA), location of rupture, gender, and previous abdominal surgery history.
RESULTS
Mean patient-age was 68.4+/-4.4 years (range: 32 to 86 years); the majority of patients were males, 135 (79.8%). Mean diameter of AAA was 6.67+/-2.0 cm (range: 4 to 15 cm); 'non-ruptured': 6.3+/-1.6 cm, 'ruptured': 7.8+/-2.6 cm. The risk of AAA rupture was statistically significantly increased with increased diameter of the AAA (P=0.007). On multivariateanalysis, the only statistically significant risk factor for AAA rupture was diameter of AAA (P=0.004).
CONCLUSION
The only significant risk factor for AAA rupture found in this study is the diameter of AAA. To minimize the rupture rate of the AAA patients, we will have to closely monitor the size of AAA diameter.