Abdominal aortic aneurysm. Experience with the use of the straight tube method of treatment.

Forty-three consecutive patients with an abdominal aortic aneurysm treated by means of a straight Dacron tube inserted inside the aneurysms are reviewed. There were no deaths among the 30 patients who had an elective operation, and three deaths in the group of 13 whose aneurysm had ruptured. The use of a straight tube to treat an abdominal aneurysm has many advantages, including lower mortality and morbidity rates. Experience suggests that this is the operation of choice for all aneurysms, whether for rupture or as an elective procedure, except for a minority of patients with aneurysms of the iliac arteries. A significant delay occurred in referral of 30% of patients, apparently owing to the belief that vascular surgery carried a grave risk. Of the patients with a ruptured aneurysm, 50% had their condition misdiagnosed; this led to delay in the patients receiving treatment. It is clear that clinicians are not sufficiently "aneurysm minded" when they examine the abdomen.