[Surgery of aneurysms of the abdominal aorta in 1992. Lessons of a decade].
Perioperative mortality of abdominal aortic aneurysm (AAA) remains at a mean of 3% in asymptomatic cases, 6% when symptomatic and 50% when ruptured while many patients with ruptured AAA die prior to surgery. This has changed little over the last decade. The causes of this stagnation are analyzed, strategic choices as a function of clinical situations, size of aneurysm, and associated lesions exposed, and means explored to improve the prognosis. Since the perioperative mortality rate appears incompressible, an improvement in the prognosis of AAA can be obtained only by a combined medical effort. This requires the more rapid recognition of prodromal symptoms of rupture, the detection of a larger number of asymptomatic AAA and improved postoperative life expectancy, already reasonable, by more rigorous vascular and cardiologic surveillance.
Mellière
D
D
Service de Chirurgie Vasculaire, CHU Henri-Mondor, Créteil.
Becquemin
J P
JP
Ecollan
P
P
Fitoussi
M
M
Vodinh
J
J
D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D006801:Humans; D011300:Preoperative Care; D011379:Prognosis
La chirurgie des anévrysmes de l'aorte abdominale en 1992. Les leçons d'une décennie.