Diagnosis and surgical treatment of abdominal aortic aneurysm:a report of 96 cases

Objective To discuss the diagnosis, selection of type of operation, and prevention and treatment of perioperative complications of abdominal aortic aneurysm (AAA). Methods The clinical data of 96 (patients) who underwent open surgical treatment of AAA, at Xijing Hospital between January, 1990 and June, 2004 were retrospectively reviewed. Among those, 82 patients with infrarenal AAA underwent aneurysmectomy and graft repair. 12 cases were treated by aneurysmal wrapping with Dacron. In 2 patients with suprarenal false AAA, lateral aneurysmectomy and repair was performed. Results The distance between renal artery and the neck of the aneurysm was determined by arteriography, MRA or EBT. Ninty-three patients were cured, and three cases died, with an operative mortality of 3.1%(3/96). The operative mortality was 50.0%(2/4) in 4 cases who had urgent operation because of ruptured AAA, while the operative mortality rate of the cases undergoing elective surgical repair was 1.1%(1/92, P0.05). Postoperative complications of AAA: 6 cases had symptoms of sigmoid colon ischemia; 2 cases had extremity ischemic symptoms; and 2 (cases) had acute renal insufficiency. All of these patients recovered completely. The total operative complication rate was 21.3%. 82 cases have been followed-up for 6 months to 15 years, and the five-year survival rate was 81.7%. Conclusions Aneurysmectomy and prosthetic vascular graft repair is the basic method of treatment for AAA.