J Thorac Cardiovasc Surg 2004;127:325-328
© 2004 The American Association for Thoracic Surgery
Prevalence of abdominal aortic aneurysm and repair outcomes on the basis of patient sex: Should the timing of intervention be the same?
Nancy L. Harthun, MDa,
Vasana Cheanvechai, MDb,
Linda M. Graham, MDc,
Julie A. Freischlag, MDd,
Vivian Gahtan, MDe,*
a Division of TCV Surgery, University of Virginia Health System, Charlottesville, Va, USA
b Division of Vascular Surgery, University of Maryland, Baltimore, Md, USA
c Department of Vascular Surgery, the Cleveland Clinic Foundation, Cleveland, Ohio, USA
d Department of Surgery, Johns Hopkins School of Medicine, Baltimore, Md, USA
e Section of Vascular Surgery, Yale University School of Medicine, New Haven, Conn, USA
Received for publication September 29, 2003; accepted for publication October 6, 2003.
* Address for reprints: Vivian Gahtan, MD, SUNY Upstate Medical University College of Medicine, Department of Surgery, 750 East Adams St, Syracuse, NY 13210 , USA
gahtanv@upstate.edu
| The first 20% of the full text of this article appears below. |
The prevalence of abdominal aortic aneurysms (AAAs) has been reported to be higher in men than in women. Most prevalence studies (AAA diagnosed by means of autopsy, ultrasound screening, and hospital discharge data) demonstrated the percentage of AAAs diagnosed in women to be 19% to 34% and the percentage diagnosed in men to be 66% to 81%.1-5 This rate appears to be reliably constant in many Western nations. No cause or causes for the dramatic difference in the prevalence of AAAs between the sexes has been identified.
Risk-factor profiles appear to be similar for both sexes. Age, cigarette smoking, and family history are all reported to have high association with AAA formation.5,6 Women are usually older than their male counterparts when they undergo AAA repair (Tables 1 and 2). 1,6-12 Men have a higher association of ischemic coronary artery disease and peripheral aneurysms (usually femoral or popliteal in location), and women have a higher incidence of concomitant aortoiliac occlusive disease.6
View this table:
[in this window]
[in a new window]
|
TABLE 1. Summary of perioperative mortality after elective abdominal aortic aneurysm repair by sex
|
|
View this table:
[in this window]
[in a new window]
|
TABLE 2. Summary of perioperative mortality after ruptured abdominal aortic aneurysm repair by sex
|
|
The decision of when to recommend repair of an AAA for women is debatable. The general consensus is that the rupture rate increases with increasing aortic diameter. The rupture rate increases dramatically as the aneurysm diameter approaches 5 cm. Generally, when the aneurysm attains this size, treatment is recommended for low-risk patients in the United States. Similarly, a 5.5-cm aneurysm diameter is . . . [Full Text of this Article]
Copyright © 2004 by The American Association for Thoracic Surgery.
