Other studies have shown that the rate of smoking has gone down with time and the use of statins has gone up. There may be better control of hypertension as well. "We think that it’s possible that for those reasons, there may be a decreasing incidence of aortic aneurysm in the United States." Data from the United Kingdom, Sweden, and Australia suggest that there may be a decline in those countries, he added.
Dr. Paty, vice chair of clinical research in the department of surgery at Memorial Sloan-Kettering Cancer Center in New York, also questioned whether the data reflect a change in practice to observing smaller aneurysms, delaying repair.
This may be the case, according to Dr. Schermerhorn. "Are we deferring aneurysms? I would agree completely." Studies have shown "that it’s safe for us to wait until the aneurysms are up in the 5.5-cm range. So I think that a lot of that redistribution of those [younger than 75 years to those just older than 75] may represent that. That should, however, decrease the rate of aneurysm repair that we do, and some patients will die of competitive causes during that observation period. So that should not be reflected in the increased rate of repair that we detected." In addition, the increased use of advanced abdominal imaging has led to the identification of more aneurysms.
The complete manuscript of this presentation is anticipated to be published in the Annals of Surgery pending editorial review.
The authors reported that they have no relevant conflicts of interest.