Abdominal Aortic Aneurysm

Abstract

Abdominal aortic aneurysms (AAA) are defined as dilatations of the aorta to a diameter 1.5 times the expected normal aortic diameter. Although they are responsible for a variety of symptomatic presentations, from embolism to frank rupture, the most common presentation is one of an incidental finding in an asymptomatic patient. History and physical exam should be focused on elucidating symptoms, as well as risk factors, and potentially palpating a pulsatile abdominal mass, although the positive predictive value of physical exam in identifying and predicting size of a AAA is notoriously poor. The preoperative imaging of choice is computed tomographic angiography. Based on imaging characteristics and preoperative risk stratification, either an endovascular or open surgical modality should be used for repair. No statistically significant differences in long-term mortality have been found between the two modalities. Postoperative surveillance is imperative following both types of repair, although necessarily more frequent following endovascular interventions.