Our Summary

This study compares the results of surgery for abdominal aortic aneurysm (AAA) in Sweden and Finland. Sweden started screening 65-year-old men for AAA in 2006 and has seen a decline in deaths related to the condition. However, the incidence of AAA has been dropping worldwide. Finland, which has a similar population and health care system to Sweden, does not have a AAA screening program.

The study looked at all AAA surgeries from 1998 to 2017. It found that in Sweden, the number of surgeries increased after the screening was introduced. Both countries saw a decrease in the number of emergency AAA surgeries, but the decrease was more noticeable in Sweden.

At the start of the study, Sweden had a higher proportion of all AAA surgeries due to emergencies, but by the end, the proportions were similar in both countries. The study also found that long-term survival improved for 65-79 year old men in Sweden after the start of screening.

The study concludes that the improvements in Sweden are likely due to the screening program, as they are not seen in Finland, which does not have a screening program.

FAQs

  1. What was the impact of the AAA screening program in Sweden on the number of surgeries and survival rates?
  2. How did the number of emergency AAA surgeries compare between Sweden and Finland from 1998 to 2017?
  3. Did the study find any improvements in Finland similar to those in Sweden, where a AAA screening program was implemented?

Doctor’s Tip

A helpful tip a doctor might give a patient about aortic aneurysm repair is to consider participating in screening programs if available, as early detection and treatment can significantly improve outcomes and reduce the risk of emergency surgeries. Additionally, it is important to follow a healthy lifestyle, including regular exercise, a balanced diet, and not smoking, to help prevent the development or progression of aortic aneurysms. Regular check-ups with a healthcare provider are also important for monitoring the condition and discussing treatment options.

Suitable For

Patients who are typically recommended aortic aneurysm repair are those who have been diagnosed with an abdominal aortic aneurysm (AAA) and are at risk for rupture or other complications. In this study, it was found that 65-year-old men in Sweden benefited from a AAA screening program, with a decrease in deaths related to the condition and improved long-term survival after surgery. Therefore, patients who may benefit from aortic aneurysm repair are those who are identified through screening programs or diagnosed with a AAA and are at risk for complications.

Timeline

Before aortic aneurysm repair:

  • Patient may experience symptoms such as abdominal or back pain, pulsating sensation in the abdomen, and sometimes chest pain or difficulty breathing
  • Diagnosis may be made through imaging tests such as ultrasound, CT scan, or MRI
  • Patient may undergo monitoring and surveillance of the aneurysm to determine if surgery is necessary
  • Patient will undergo pre-operative assessments and preparation for surgery

After aortic aneurysm repair:

  • Patient will undergo surgery to repair the aneurysm, which may be done through open surgery or endovascular repair
  • Recovery time will vary depending on the type of surgery performed
  • Patient will be monitored closely for any complications or signs of reoccurrence of the aneurysm
  • Patient will likely need to make lifestyle changes to reduce the risk of future aneurysms, such as quitting smoking and maintaining a healthy diet and exercise routine
  • Long-term follow-up will be necessary to monitor the health of the repaired aorta.

What to Ask Your Doctor

  1. What is an aortic aneurysm and why is it important to repair it?
  2. What are the different treatment options for repairing an aortic aneurysm?
  3. How do I know if I am a candidate for surgery to repair my aortic aneurysm?
  4. What are the potential risks and complications associated with aortic aneurysm repair surgery?
  5. What is the recovery process like after aortic aneurysm repair surgery?
  6. How long will it take for me to fully recover and resume normal activities after surgery?
  7. Will I need to take any medications or make any lifestyle changes after aortic aneurysm repair surgery?
  8. How often will I need to follow up with you after surgery for monitoring and surveillance?
  9. What signs or symptoms should I watch out for that may indicate a complication after surgery?
  10. How will my long-term prognosis be affected by undergoing aortic aneurysm repair surgery?

Reference

Authors: Laine MT, Mani K, Gunnarsson K, Wanhainen A, Sund R, Venermo M. Journal: Eur Heart J. 2024 Nov 21;45(44):4747-4757. doi: 10.1093/eurheartj/ehae665. PMID: 39374339