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Background: Few data are available on the long-term outcome of endovascular repair of abdominal aortic aneurysm as compared with open repair. Methods: From 1999 through 2004 at 37 hospitals in the United Kingdom, we randomly assigned 1252 patients with large abdominal aortic aneurysms (≥5.5 cm in diameter) to undergo either endovascular or open repair; 626 patients were assigned to each group. Patients were followed for rates of death, graft-related complications, reinterventions, and resource use until the end of 2009. Logistic regression and Cox regression were used to compare outcomes in the two groups. Results: The 30-day operative mortality was 1.8% in the endovascular-repair group and 4.3% in the open-repair group (adjusted odds ratio for endovascular repair as compared with open repair, 0.39; 95% confidence interval [CI], 0.18 to 0.87; P=0.02). The endovascular-repair group had an early benefit with respect to aneurysm-related mortality, but the benefit was lost by the end of the study, at least partially because of fatal endograft ruptures (adjusted hazard ratio, 0.92; 95% CI, 0.57 to 1.49; P=0.73). By the end of follow-up, there was no significant difference between the two groups in the rate of death from any cause (adjusted hazard ratio, 1.03; 95% CI, 0.86 to 1.23; P=0.72). The rates of graft-related complications and reinterventions were higher with endovascular repair, and new complications occurred up to 8 years after randomization, contributing to higher overall costs. Conclusions: In this large, randomized trial, endovascular repair of abdominal aortic aneurysm was associated with a significantly lower operative mortality than open surgical repair. However, no differences were seen in total mortality or aneurysm-related mortality in the long term. Endovascular repair was associated with increased rates of graft-related complications and reinterventions and was more costly. (Current Controlled Trials number, ISRCTN55703451.) N Engl J Med 2010;362:1863-71. [ABSTRACT FROM AUTHOR]

Examines changes in the mortality rate from aortic aneurysm in the screened portion of the population in Great Britain. Increase in the rate of detection and increased numbers of elective aneurysm repairs; Influence of the screening program on community mortality rate; Analysis of aneurysm related deaths in men eligible for screening.

The article discusses the programs supported by the National Health Service in England and Scotland about ultrasonographic screening to detect abdominal aortic aneurysms (AAA). It shows that AAA are detectable with ultrasonography for low mortality and reduce cost-effectiveness on screening study. In the study, researchers used a Markov model to estimate the cost-effectiveness of ultrasonographic screening and multiplication of eclectic probabilities.

Abdominal aortic aneurysm (AAA) disease is a condition that affects mainly men over the age of 65 years. The majority of AAAs will remain asymptomatic and therefore undetected. These undetected aneurysms will invariably grow enough for their walls to rupture leading to death in nearly 75% of those affected. Ultrasound-based AAA screening has been shown to reduce the risk of dying of an AAA by half. This significant reduction of mortality offered by a simple and sensitive non-invasive test has prompted the Department of Health to introduce a national AAA screening programme for England and Wales. In this article, the public health risks of AAA disease together with details of the impact of the anticipated national AAA screening programme are discussed. [ABSTRACT FROM AUTHOR]

The article discusses a study which examined the declining mortality from abdominal aortic aneurysm (AAA) rupture in Great Britain. The study reviewed routine statistics for mortality, hospital admissions and procedures in England and Wales. It showed a decrease in mortality from AAA among men from 2007 to 2011. It associated the decline to a reduced prevalence of smoking.

BACKGROUND Studies with short-term follow-up have shown that screening for abdominal aortic aneurysm (AAA) is cost-effective and reduces mortality. OBJECTIVE To evaluate the long-term cost-effectiveness and mortality benefit of screening for AAA. DESIGN AND INTERVENTION The Multicentre Aneurysm Screening Study (MASS) was a randomized trial conducted at four centers in the UK between 1997 and 1999. Men aged 65-74 years, identified through family physician records, were eligible for inclusion in the study. Individuals with a terminal illness, previous AAA surgery, or a known AAA, were excluded. Participants were randomly assigned to receive an invitation to AAA ultra-sonography screening or to not receive an invitation. Men with an aortic diameter greater than 3.0cm were classified as having an AAA. Invitations to yearly screening were issued to those with an aortic diameter of 3.0-4.4cm. Screening every 3 months was recommended for those with an aortic diameter of 4.5-5.4 cm. Individuals with signs or symptoms of AAA, an aortic diameter exceeding 5.5cm, or aortic expansion of 1.0cm or more within a year, were eligible for surgery. Rescreening was not offered to participants with an aortic diameter of less than 3.0cm. Patients were followed up through hospital records and the UK Office of National Statistics. The 4-year outcomes of this study have previously been reported. OUTCOME MEASURES The primary end point was AAA-related death. All-cause mortality and cost-effectiveness were also assessed. RESULTS After exclusions, a total of 67,770 men were randomized; 33,883 were assigned to receive invitations to screening and the remaining 33,887 formed the control group. The mean age of participants was 69.2 years for both groups. Screening attendance was high in the invited group (27,204 attended; 80%) and 1,334 men were identified as having an AAA. After 7 years, there had been 14,001 all-cause deaths, of which 301 were AAA-related. In addition, 24% of all participants did not attend recall scans and were, therefore, lost to clinical follow-up. Compared with the control group, the hazard ratio for AAA-related mortality at 7 years in the patients invited for screening was 0.53 (95% CI 0.42-0.68) and 0.96 (95% CI 0.93-1.00) for all-cause mortality. The rate of AAA rupture in men who had an aortic diameter of less than 3.0cm was low at approximately 0.54 ruptures per 100,000 person years. The cost-effectiveness at 7 years was estimated to be US$19,500 (95% CI $12,400-$39,800) per life-year gained for AAA-related mortality and $7,600 (95% CI $3,300-$00 per life-year gained for all-cause mortality. CONCLUSION AAA screening of men aged 65-74 years is cost-effective and is associated with approximately a 50% reduction in AAA-related mortality. [ABSTRACT FROM AUTHOR]

Investigates the correlation between operative workload and in-hospital mortality for elective and emergency operations on aortic aneurysm in a study in Great Britain. Total number of operations investigated; Findings revealed by parabolic regression and log-arithmetic transformation; Observation on the mortality rate of patients.