Prevalence
Although AAA is one of the most serious cardiovascular diseases, most AAA's are never detected. Approximately 70% to 80% of AAA patients are asymptomatic at the time of initial diagnosis. AAA's are generally discovered inadvertently during procedures to diagnose unrelated medical conditions. Each year approximately 190,000 AAA's are diagnosed in the United States and 45,000 - 50,000 patients undergo surgery. AAA's are generally more prevalent in people over the age of 60 and are more common in men than in women.
The minimally invasive treatment of AAA requires only a small incision in the femoral artery of the leg, minimizing both hospital lengths of stay and the amount of time required for convalescence. The adoption of less invasive treatments will be segmented by the size of the aneurysm and is expected to phase in over time. There are a number of factors that may increase the number of patients seeking these less invasive technologies:
- An elderly population growing at a higher rate than that of the general population in industrialized countries. In 2000, the age 65 and over population in the United States numbered approximately 34 million or 12.4% of the total population, and is growing at a higher growth rate than the overall U.S. population. In the United States, the vast majority of AAA cases are performed in patients age 65 and over. A study cited recently in the New England Journal of Medicine estimates that up to 9% of people over 65 have a non-diagnosed, asymptomatic AAA.*
- The Screening Abdominal Aortic Aneurysms Very Efficiently Act (SAAAVE) was signed into law on February 8, 2006 in the United States. The Act will provide one-time abdominal aortic aneurysm (AAA) screening for males who have ever smoked and for males or females who have a family history of the disease. Screening will be provided as part of the Welcome to Medicare physical and will be covered on January 1, 2007.
- An aging "baby boomer" population with high expectations of maintaining their active lifestyles. Baby boomers, on average, exercise more frequently and live more active lifestyles than the average American. As baby boomers age, their more active lifestyle, combined with their strong desire to maintain the quality of life to which they are accustomed, make them increasingly likely to seek minimally invasive alternatives and forego the long convalescence period required by conventional surgical alternatives.
- Increased non-invasive AAA screening. Recently published articles in the British Journal of Surgery and reports from the European Society of Vascular Surgery have reported that AAA screening at age 65 reduces mortality from AAA disease. We believe that not unlike obtaining a baseline colonoscopy or mammogram, non-invasive testing and minimally invasive alternatives for treatment of AAA will increase the number of patients seeking screening for this serious medical condition.
*Thompson, R.W., Detection and Management of Small Aortic Aneurysms, N Engl J Med, Vol. 346, No 19, May 9 2002, page 1484.