Abdominal aortic aneurysm. An interhospital study of 171 surgically treated patients.

A retrospective interhospital study of 171 surgically treated patients with atherosclerotic abdominal aortic aneurysm is presented (Orebro and Göteborg). Elective resection of the aneurysm was performed in 94 of the patients and emergency resection because of rupture or suspected rupture of the aneurysm in 77 cases. The mortality within the first postoperative month was 16% in the electively operated patients and 49% in the emergency operated patients. During the last 3 years, the mortality rate among electively operated patients was considerably lower (10%). The five-year survival rate was more than 50% in the electively operated patients. The main difference in long-term survival rate between emergency and electively operated patients was dependent on the primary mortality. The cause of late death was usually not related to the operation of the aneurysm, but to other manifestations of generalized atherosclerotic disease. The results seem to justify the conclusion that atherosclerotic abdominal aortic aneurysm should be resected irrespective of size and symptoms, unless the patient has symptoms of severe arterial hypertension and/or generalized atherosclerosis.