Journal of Vascular Surgery
Volume 48, Issue 6 , Pages 1375-1381 , December 2008

Fit patients with small abdominal aortic aneurysms (AAAs) do not benefit from early intervention

Presented at the 2007 Vascular Annual Meeting, Baltimore, Md, Mar 21-24, 2007.

  • Louise C. Brown, PhD, B'Eng, MSc

      Affiliations

    • Department of Vascular Surgery Research Group, Imperial College, London, United Kingdom
    • Corresponding Author InformationCorrespondence: Louise C. Brown, PhD, Vascular Surgery Research Group, Imperial College Department of Surgery, 4th Floor, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, United Kingdom
  • ,
  • Simon G. Thompson, DSc, MA

      Affiliations

    • Medical Research Council Biostatistics Unit, Cambridge, United Kingdom
  • ,
  • Roger M. Greenhalgh, MD

      Affiliations

    • Department of Vascular Surgery Research Group, Imperial College, London, United Kingdom
  • ,
  • Janet T. Powell, MD

      Affiliations

    • Department of Vascular Surgery Research Group, Imperial College, London, United Kingdom
  • ,
  • UK Small Aneurysm Trial Participants

Received 16 May 2008 ,Accepted 7 July 2008.

References 

  1. The UK Small Aneurysm Trial Participants. Mortality results for randomized controlled trial of early elective surgery or ultrasonographic surveillance for small abdominal aortic aneurysms. Lancet. 1998;352:1649–1655
  2. The United Kingdom Small Aneurysm Trial Participants. Long-term outcomes of immediate repair compared with surveillance of small abdominal aortic aneurysms. N Engl J Med. 2002;346:1445–1452
  3. Lederle FA, Wilson SE, Johnson GR, Reinke DB, Littooy FN, Acher CW, et al. Immediate repair compared with surveillance of small abdominal aortic aneurysms. N Engl J Med. 2002;346:1437–1444
  4. Powell JT, Brown LC, Forbes JF, Fowkes FG, Greenhalgh RM, Ruckley CV, et al. Final 12-year follow-up of surgery versus surveillance in the UK Small Aneurysm Trial. Br J Surg. 2007;94:702–708
  5. Cao P. Comparison of surveillance vs Aortic Endografting for Small Aneurysm Repair (CAESAR) trial: study design and progress. Eur J Vasc Endovasc Surg. 2005;30:245–251
  6. Ouriel K. Does the availability of endovascular grafts change the size threshold for repair? (2005 Endovascular Today). www.evtoday.com/PDFarticles/0305/F1_Ouriel.htmlAccessed August 20, 2007
  7. Peppelenbosch N, Buth J, Harris PL, van Marrewijk C, Fransen G EUROSTAR Collaborators. Diameter of abdominal aortic aneurysm and outcome of endovascular aneurysm repair: does size matter? (A report from EUROSTAR). J Vasc Surg. 2004;39:288–297
  8. Schermerhorn ML, Birkmeyer JD, Gould DA, Cronenwett JL. Cost-effectiveness of surgery for small abdominal aortic aneurysms on the basis of data from the United Kingdom small aneurysm trial. J Vasc Surg. 2000;31:217–226
  9. Cronenwett JL. Endovascular aneurysm repair: important mid-term results. Lancet. 2005;365:2156–2158
  10. Brewster DC, Cronenwett JL, Hallett JW, Johnston KW, Krupski WC, Matsumura JS. Guidelines for the treatment of abdominal aortic aneurysms (Report of a subcommittee of the Joint Council of the American Association for Vascular Surgery and Society for Vascular Surgery). J Vasc Surg. 2003;37:1106–1117
  11. Brown LC, Greenhalgh RM, Howell S, Powell JT, Thompson SG. Patient fitness and survival after abdominal aortic aneurysm repair in patients from the UK EVAR trials. Br J Surg. 2007;94:709–716
  12. Baas AF, Janssen KJ, Prinssen M, Buskens E, Blankensteijn JD. The Glasgow Aneurysm Score as a tool to predict 30-day and 2-year mortality in the patients from the Dutch Randomized Endovascular Aneurysm Management trial. J Vasc Surg. 2008;47:277–281
  13. Kertai MD, Steyerberg EW, Boersma E, Bax JJ, Vergouwe Y, van Urk H, et al. Validation of two risk models for perioperative mortality in patients undergoing elective abdominal aortic aneurysm surgery. Vasc Endovascular Surg. 2003;37:13–21
  14. Kertai MD, Boersma E, Klein J, van Sambeek M, Schouten O, van Urk H, et al. Optimizing the prediction of perioperative mortality in vascular surgery by using a customized probability model. Arch Intern Med. 2005;165:898–904
  15. The UK Small Aneurysm Trial Participants. The UK Small Aneurysm Trial: design, methods and progress. Eur J Vasc Endovasc Surg. 1995;9:42–48
  16. Lee TH, Marcantonio ER, Mangione CM, Thomas EJ, Polanczyk CA, Cook EF, et al. Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery. Circulation. 1999;100:1043–1049
  17. Steyerberg EW, Kievit J, de Mol Van Otterloo JC, van Bockel JH, Eijkemans MJ, Habbema JD. Perioperative mortality of elective abdominal aortic aneurysm surgery (A clinical prediction rule based on literature and individual patient data). Arch Intern Med. 1995;155:1998–2004
  18. Biancari F, Leo E, Ylonen K, Vaarala MH, Rainio P, Juvonen T. Value of the Glasgow Aneurysm Score in predicting the immediate and long-term outcome after elective open repair of infrarenal abdominal aortic aneurysm. Br J Surg. 2003;90:838–844
  19. Brown LC, Powell JT. Risk factors for aneurysm rupture in patients kept under ultrasound surveillance (UK Small Aneurysm Trial Participants). Ann Surg. 1999;230(3):289–296September
  20. Prytherch DR, Sutton GL, Boyle JR. Portsmouth POSSUM models for abdominal aortic aneurysm surgery. Br J Surg. 2001;88:958–963
  21. Urbonavicius S, Vorum H, Urbonaviciene G, Trumpickas M, Pavalkis D, Honoré B. Predictors of post-operative mortality following treatment for non-ruptured abdominal aortic aneurysm. Curr Control Trials Cardiovasc Med. 2005;6:14
  22. Ashton HA, Buxton MJ, Day NE, Kim LG, Marteau TM, Scott RA, et al. The Multicentre Aneurysm Screening Study (MASS) into the effect of abdominal aortic aneurysm screening on mortality in men: a randomized controlled trial. Lancet. 2002;360(9345):1531–1539November 16
  23. Kim LG, P Scott RA, Ashton HA, Thompson SG Multicentre Aneurysm Screening Study Group. A sustained mortality benefit from screening for abdominal aortic aneurysm. Ann Intern Med. 2007;146(10):699–706
  24. Chichester Aneurysm Screening Group; Viborg Aneurysm Screening Study; Western Australian Abdominal Aortic Aneurysm Program; Multicentre Aneurysm Screening Study. A comparative study of the prevalence of abdominal aortic aneurysms in the United Kingdom, Denmark, and Australia. J Med Screen. 2001;8:46–50
  25. Cosford PA, Leng GC. Screening for abdominal aortic aneurysm. Cochrane Database Syst Rev. 2007;(2):CD002945
  26. EVAR Trial Participants. Endovascular aneurysm repair and outcome in patients unfit for open repair of abdominal aortic aneurysm (EVAR trial 2): randomised controlled trial. Lancet. 2005;365:2187–2192

 Competition of interest: none.

 CME article

 Additional material for this article may be found online at www.jvascsurg.org.

PII: S0741-5214(08)01149-X

doi: 10.1016/j.jvs.2008.07.014

Journal of Vascular Surgery
Volume 48, Issue 6 , Pages 1375-1381 , December 2008