Prognosis

The natural course involves slow and steady growth. With progressive aneurysm enlargement, the risk of AAA rupture increases.[3]​ Most patients with rupture will not survive to reach the operating suite; mortality from ruptured abdominal aortic aneurysms is estimated to be 80% to 90%.[5]​ Given the morbidity and mortality associated with surgical intervention, repair is typically deferred until the theoretical risk of rupture exceeds the estimated risk of operative mortality. The majority of patients undergoing open repair remain without significant graft-related complications during the remainder of their lives (0.4% to 2.3% incidence of late graft-related complications).​[265]​ Five-year survival rates after intact aneurysm repair average 60% to 75%. Those undergoing endovascular aneurysm repair (EVAR) are more likely to have a delayed complication and require re-intervention and late survival may be worse in patients undergoing EVAR for intact AAA.​[167]​​​[168][175]​ Other risk factors for poor outcome include skeletal muscle mass; there is a significant link between low skeletal muscle mass and morbidity following AAA repair.[266]​ In elderly patients there is an early deterioration in postoperative quality of life, with a delay to mental health recovery of about 4 to 6 weeks, and to physical health recovery of 1 to 3 months, regardless of operative technique. However, quality of life does return to baseline and is maintained in the long term, supporting surgical intervention for AAA in elderly patients.[267]​ 

Use of this content is subject to our disclaimer