Clinical Analysis of Abdominal Aortic Aneurysm

Lee, Kyeong Cheol; Jung, Suk In; Park, Chung Hwa; Joh, Yong Geul; Um, Jun Won; Lee, Jae Bok; Choi, Sang Yong; Whang, Cheung Wung

Abstract

PURPOSE: As a common and dangerous disease, an abdominal aortic aneurysm (AAA) occurs in approximately 2-4% of the general population and recently the incidence of AAA has been gradually increasing in Korea. Since rupture of an AAA is recognized as a lethal event, a more aggressive policy of early diagnosis and of an elective repair of the AAA are that can be performed with a mortality rate of less than 5 percent is the approach of choice for treating an AAA nowadays. METHODS: This retrospective study reports our experience managing forty-two patients with an AAA who had been operated on between January 1993 and December 1999 at Korea University hospitals. RESULTS: Thirty- seven of the patients were male, and five were female. The mean age was 67.1 years. The most common clinical manifestation was abdominal pain in 26 cases (61.9%), followed by abdominal pulsatile mass in 20 cases (47.6%), and back pain in 12 cases (28.5%). The most common associated disease was hypertension in 24 cases (57.1%). An abdominal CT scan was performed in 26 cases (61.9%) and was the most commonly used method for diagnosis. Emergency repair of the AAA was performed in 10 cases; the repair was performed electively in the other cases. Among the 42 aortic grafts implanted for AAA repair, 37 were bifurcated Y grafts and 4 were straight tube grafts. Axillobifemoral bypass surgery was performed in the case of one infected aneurysm. Among the 42 cases, 10 cases (23.8%) experienced ruptures, requiring 4 urgent operation and 6 emergency procedures. Among the 42 cases, 6 patients (14.2%) expired. In the elective cases, one (3.1%) expired. In the urgent cases, one (25.0%) expired, and in the emergency cases, four (66.6%) expired. CONCLUSION: This study showed that an AAA should be considered as a possible cause of unexplained abdominal pain in aged patients. In such patients, various diagnostic tools must be used to eliminate the possibility of an abdominal aortic aneurysm. Early diagnosis and elective surgery are crucial for a better outcome in the management of patients with an abdominal aortic aneurysm.