ruptured AAA. You don't want to have it. The VA or your Dr should have done an abd US looking for this in all men who have smoked over 100 cigs beginning at age 65-75 or earlier if FH.

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Prognosis of ruptured abdominal aortic aneurysms in Denmark from 1994–2008Short Report(296) Views (61) Full article downloadsAuthors: Lindholt JS, Søgaard R, Laustsen JPublished Date May 2012 Volume 2012:4 Pages 111 - 113DOI: http://dx.doi.org/10.2147/CLEP.S31098Jes S Lindholt1, Rikke Søgaard2, Jesper Laustsen31Vascular Research Unit, Department of Vascular Surgery, Viborg Hospital, Clinical Institute, University of Aarhus, 2Centre for Applied Health Service Research and Technology Assessment, Institute of Public Health, University of Southern Denmark, 3Department of Vascular Surgery, Aarhus University Hospital, DenmarkIntroduction: Few modern population-based estimates of the prognosis of ruptured abdominal aortic aneurysm (rAAA) exist.Methods and materials: From 1994–2008, a total of 6954 rAAA cases were identified in Danish nationwide population-based registries.Results: Of 3148 (45%) surgery cases, 1454 (46%) died within 30 days of surgery. The overall mortality risk of rAAA was 76%. The proportion of patients who received surgery increased from 44%, in the first study period, to 47% in the last study period; the 30-day postoperative mortality rate decreased from 51% to 42%; and the overall mortality risk declined significantly from 77% to 74% (odds ratio: 0.86: 95% confidence interval: 0.77–0.97). However, the age-adjusted mortality rate remained unchanged, due to the increased incidence of rAAA.J Vasc Surg. 2011 Jul;54(1):1-12.e6; discussion 11-2. Epub 2011 Apr 17.Effect of gender on long-term survival after abdominal aortic aneurysm repair based on results from the Medicare national database.Egorova NN, Vouyouka AG, McKinsey JF, Faries PL, Kent KC, Moskowitz AJ, Gelijns A.SourceDepartment of Health Evidence and Policy, Mount Sinai School of Medicine, New York, NY, USA.AbstractOBJECTIVES:Historically, women have higher procedurally related mortality rates than men for abdominal aortic aneurysm (AAA) repair. Although endovascular aneurysm repair (EVAR) has improved these rates for men and women, effects of gender on long-term survival with different types of AAA repair, such as EVAR vs open aneurysm repair (OAR), need further investigation. To address this issue, we analyzed survival in matched cohorts who received EVAR or OAR for both elective (eAAA) and rupturedAAA (rAAA).METHODS:Using the Medicare Beneficiary Database (1995-2006), we compiled a cohort of patients who underwent OAR or EVAR for eAAA (n = 322,892) or rAAA (n = 48,865). Men and women were matched by propensity scores, accounting for baseline demographics, comorbid conditions, treating institution, and surgeon experience. Frailty models were used to compare long-term survival of the matched groups.RESULTS:Perioperative mortality for eAAAs was significantly lower among EVAR vs OAR recipients for both men (1.84% vs 4.80%) and women (3.19% vs 6.37%, P < .0001). One difference, however, was that the survival benefit of EVAR was sustained for the 6 years of follow-up in women but disappeared in 2 years in men. Similarly, the survival benefit of men vs women after elective EVAR disappeared after 1.5 to 2 years. For rAAAs, 30-day mortality was significantly lower for EVAR recipients compared with OAR recipients, for both men (33.43% vs 43.70% P < .0001) and women (41.01% vs 48.28%, P = .0201). Six-year survival was significantly higher for men who received EVAR vs those who received OAR (P = .001). However, the survival benefit for women who received EVAR compared with OAR disappeared in 6 months. Survival was also substantially higher for men than women after emergent EVAR (P = .0007).CONCLUSIONS:Gender disparity is evident from long-term outcomes after AAA repair. In the case for rAAA, where the long-term outcome for women was significantly worse than for men, the less invasive EVAR treatment did not appear to benefit women to the same extent that it did for men. Although the long-term outcome after open repair for elective AAA was also worse for women, EVAR benefit for women was sustained longer than for men. These associations require further study to isolate specific risk factors that would be potential targets for improving AAA management.