ITALIAN ANEURYSM AWARDS

The Rotary Club of Napoli (Naples), Italy, is fighting back against a health condition that, if undetected, can rupture the abdominal aorta without warning and cause almost instant death.

An abdominal aortic aneurysm is a bulging, weak section of the abdominal aorta that may rupture.  About three-quarters of people who suffer such a break do not live long enough to undergo surgery. Of those who do, over 40 percent do not survive.

Since the Napoli (Naples) club developed a screening program in 1999, local physicians have seen more than 6,950 people ages 65 and older, the age group most at risk. Through the country’s national health service, doctors have performed free, potentially lifesaving surgeries on 403 Naples residents.

“The screening program must become commonplace,” says vascular surgeon and club member Gaetano de Donato. “The number of deaths in the United States caused by ruptures has become comparable to those from breast or prostate cancer.”

The Rotarians originally committed themselves to this cause after de Donato presented a program about the dangers of aneurysms to his club. With support from the eight other Naples clubs, and from funds generated by a musical comedy benefit show, club members sent over 3,700 letters explaining the aneurysms and associated risk factors. More than 40 percent of recipients responded and participated in free ultrasound screening sessions during the project’s first three years.

In 2003, the club staged another musical benefit and, during the next six years, extended the project to two more city districts in Naples.

As part of the screening program, de Donato and his medical staff, including two other physicians, volunteered their time one afternoon a week. Tests revealed aneurysms that were manageable without surgery in more than 200 of the patients, for whom de Donato  prescribed medicine and lifestyle changes to address risk factors including high blood pressure, diabetes, and smoking. For patients with larger aneurysms, de Donato performed surgery, either substituting a synthetic tube for the weakened portion of a patient’s aorta or using a stent to strengthen the vessel internally.

“Success is strictly dependent on the treatment timing,” says de Donato, whose fellow club members are contacting the remaining two-thirds of the city’s at-risk residents. “The key aspect is to perform a very early diagnosis in at-risk patients.”

In light of the Napoli (Naples) club’s success, the Rotary clubs of Aversa-Terra Normanna, Caserta-Terra-di-Lavoro, Cosenza, Cosenza Nord, and Salerno-Est have started their own abdominal aortic aneurysm screening programs.