Less-invasive surgery isn’t necessarily better than an open procedure to repair a potentially fatal abdominal aortic aneurysm. That’s the conclusion of researchers at the Johns Hopkins University School of Medicine, who found similar survival rates for both types of procedures.
The medical community was enthusiastic about a new, less-invasive procedure assumed to be safer and better than traditional open surgery, according to Medical News Today. The researchers followed patients for up to nine years. Surprisingly, they found that after four years, survival rates for the two types of surgery were very similar.
An aneurysm is a bulge resembling a balloon in an artery. When the artery’s wall has been weakened by genetic issues, trauma, or certain medical problems, the pressure of blood against it can cause an aneurysm. Aneurysms in the aorta claim the lives of around 13,000 Americans a year, says the National Heart Lung and Blood Institute. Most deaths occur after the rupture of an aneurysm or a split in the aorta’s wall.
An abdominal aortic aneurysm occurs when the aorta — the body’s largest blood vessel — balloons in the abdomen due to pressure on the wall. If it ruptures, massive bleeding can be quickly fatal. This type of aneurysm ranks 14th among leading causes of death for Americans between 60 and 85.
Treatment depends on an aneurysm’s size and location. The traditional surgery for an abdominal aortic aneurysm utilizes a large, open cut. The more recent type of repair is an endovascular embolization, in which the surgeon uses a stent to prop open the blood vessel or reinforce its wall, according to PubMed Health.
While the survival rate was higher after two years in patients in the Hopkins study who had undergone endovascular repair, by the four-year mark, rates were nearly the same. Among elderly patients considered bad risks for an open surgery, individuals didn’t fare better with the newer technique. The team found no increased survival in patients at least 70 years old who had undergone the less-invasive procedure. Any benefits occurred in younger individuals.
Study leader Julie A. Freischlag, M.D., says the results raise an issue over who should undergo aneurysm repair. Even when older patients underwent repairs, their lives weren’t prolonged. She says the issue is whether they should have either procedure, since they’re already dying of diseases associated with old age.
My father lived, largely symptom-free, for years with an abdominal aortic aneurysm . Citing a weak heart, surgeons declined to repair it. When he experienced sudden pain, my mother took him to the emergency room. He survived an open repair procedure but died after 16 days in intensive care of an infection at the surgical site. Although he was 71, we wonder if an endovascular embolization would have provided a different outcome, at least for four years after surgery.
Vonda J. Sines has published thousands of print and online health and medical articles. She specializes in diseases and other conditions that affect the quality of life.
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