Late results of small untreated abdominal aortic aneurysms
Late results of small untreated abdominal aortic aneurysms
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未经治疗的小型腹主动脉瘤的晚期结果
DOI：
10.1007/bf02015297
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发表时间：
1991
影响因子：
1.5
通讯作者：
W. Wagner
中科院分区：
文献类型：
--
作者：
R. Treiman;S. Hartunian;D. Cossman;R. Foran;J. Cohen;P. Levin;W. Wagner
我们报告了73例直径小于5 cm的腹主动脉瘤患者的经验，这些患者最初被选择接受非手术治疗。通过超声（34）、动脉造影（16）、计算机断层扫描（17）、X线平片（4）和磁共振成像（2）确定动脉瘤的大小。研究的终点是随后的选择性切除、破裂、破裂以外的原因导致的死亡或随访至少三年的完整动脉瘤。总体而言，28例（38%）动脉瘤随后择期切除; 4例（5%）破裂; 15例（21%）在患者死亡时完好; 26例（36%）在3 - 6.5年随访期间保持完好。选择性切除的适应症为动脉瘤扩大（21）;提示即将破裂的症状（3）;以及医疗状况改善（4）。在最初直径小于4 cm的43个动脉瘤中，16个（37%）进行了择期切除，1个（2%）破裂，在4-4.9 cm的30个动脉瘤中，12个（40%）切除，3个（10%）破裂。破裂的4个动脉瘤在破裂前已扩大至5 cm以上。我们得出结论，小于4 cm的动脉瘤可以安全随访。4-4.9 cm的动脉瘤应考虑手术，这取决于动脉瘤的大小、患者的预期寿命和手术风险因素。任何扩大的动脉瘤都应该切除，特别是如果动脉瘤直径大于5 cm。
We report our experience with 73 patients who were initially selected for nonoperative management of an abdominal aortic aneurysm less than 5 cm in diameter. Size of the aneurysm was determined by ultrasound (34); arteriography (16); computerized tomography (17); plain x-ray (4); and magnetic resonance imaging (2). End points of the study were subsequent elective resection, rupture, death from cause other than rupture, or an intact aneurysm followed for a minimum of three years. Overall, 28 (38%) aneurysms were subsequently resected on an elective basis; four (5%) ruptured; 15 (21%) were intact at the time of the patient's death; and 26 (36%) remained intact during follow-up of 3 to 6.5 years. Indications for elective resection were aneurysm enlargement (21); symptoms suggesting impending rupture (3); and improvement in medical condition (4). In the 43 aneurysms initially less than 4 cm diameter, 16 (37%) had elective resection and one (2%) ruptured, and in the 30 that were 4–4.9 cm, 12 (40%) were resected and three (10%) ruptured. The four aneurysms that ruptured had enlarged to greater than 5 cm prior to rupture. We conclude that aneurysms less than 4 cm can be safely followed. Aneurysms 4–4.9 cm should be considered for operation, depending upon the size of the aneurysm, patient's life expectancy, and risk factors for surgery. Any aneurysm that enlarges should be resected, especially if the aneurysm becomes larger than 5 cm in diameter.
影响因子：
158.5
作者：
NEVITT, MP;BALLARD, DJ;HALLETT, JW
通讯作者：
HALLETT, JW