2. • DEFINITION: FOCAL DILATION 1.5X GREATERDEFINITION: FOCAL DILATION 1.5X GREATER
THAN THE NORMAL DIAMETER OF THE ARTERYTHAN THE NORMAL DIAMETER OF THE ARTERY
(>3 CM)(>3 CM)
• TRUE ANEURYSM (ALL 3 LAYERS) VS.TRUE ANEURYSM (ALL 3 LAYERS) VS.
PSEUDOANEURYSMPSEUDOANEURYSM
• INFRARENAL ABDOMINAL AORTA MOSTINFRARENAL ABDOMINAL AORTA MOST
COMMON LOCATIONCOMMON LOCATION
• CAN INVOLVE SUPRARENAL AORTA, ILIACCAN INVOLVE SUPRARENAL AORTA, ILIAC
ARTERIESARTERIES
8. • PROGRESSIVE ENLARGEMENT LEADING TO RUPTURE,PROGRESSIVE ENLARGEMENT LEADING TO RUPTURE,
EXSANGUINATION AND DEATHEXSANGUINATION AND DEATH
• TENTH LEADING CAUSE OF DEATH AMONG MEN >65 YEARS OLDTENTH LEADING CAUSE OF DEATH AMONG MEN >65 YEARS OLD
• ACTUAL DEATH RATE LIKELY EXCEEDS 15,000 REPORTED DEATHSACTUAL DEATH RATE LIKELY EXCEEDS 15,000 REPORTED DEATHS
ANNUALLY, BECAUSE SUDDEN DEATH IS OFTEN MISTAKENLYANNUALLY, BECAUSE SUDDEN DEATH IS OFTEN MISTAKENLY
ATTRIBUTED TO MIATTRIBUTED TO MI
9. • RUPTURE IS THE GRAVEST AND MOSTRUPTURE IS THE GRAVEST AND MOST
COMMON COMPLICATIONCOMMON COMPLICATION
• OTHER COMPLICATIONS INCLUDE:OTHER COMPLICATIONS INCLUDE:
• PERIPHERAL EMBOLIZATIONPERIPHERAL EMBOLIZATION
• AORTIC THROMBOSISAORTIC THROMBOSIS
• FISTULA FORMATIONFISTULA FORMATION
• AORTO-DUODENALAORTO-DUODENAL
• AORTO-CAVALAORTO-CAVAL
• LOCAL COMPRESSION/MASS EFFECTLOCAL COMPRESSION/MASS EFFECT
• HYDRONEPHROSISHYDRONEPHROSIS
10. AAA Diameter Annual Rupture Rate
4.0 – 5.4 cm 0.5 – 1.0%
5.5 – 6.4 cm 10%
6.5 – 6.9 cm 19%
7.0 – 7.9 cm 32%
> 8.0 cm 50%
11. • RUPTURED AAA 90% MORTALITYRUPTURED AAA 90% MORTALITY
• ELECTIVE REPAIR <5% MORTALITYELECTIVE REPAIR <5% MORTALITY
• EARLY DIAGNOSIS AND ELECTIVEEARLY DIAGNOSIS AND ELECTIVE
REPAIR CAN REDUCE MORTALITYREPAIR CAN REDUCE MORTALITY
FROM AAAFROM AAA
• SCREENING HIGH RISKSCREENING HIGH RISK
POPULATIONS IS COST EFFECTIVEPOPULATIONS IS COST EFFECTIVE
AND REDUCES AAA-RELATEDAND REDUCES AAA-RELATED
MORTALITYMORTALITY
38. • LESS INVASIVE PROCEDURELESS INVASIVE PROCEDURE
• AAA EXCLUDED FROM CIRCULATION WITH INTRALUMINAL STENT-AAA EXCLUDED FROM CIRCULATION WITH INTRALUMINAL STENT-
GRAFTGRAFT
• ENDO HAS LOWER PERIOP MORBIDITY AND MORTALITY RATES BUT MAYENDO HAS LOWER PERIOP MORBIDITY AND MORTALITY RATES BUT MAY
BE LESS DURABLE AND REQUIRES MORE FREQUENT FOLLOW-UP THANBE LESS DURABLE AND REQUIRES MORE FREQUENT FOLLOW-UP THAN
OPEN REPAIROPEN REPAIR
• TYPICALLY RESERVED FOR ELDERLY OR HIGH RISK PATIENTTYPICALLY RESERVED FOR ELDERLY OR HIGH RISK PATIENT