AAA

  • Cardiology
  • 25 Vascular
    • AAAs can be surgically repaired via open surgery or endovascular aneurysm repair (EVAR). All things being equal EVAR has been associated with a lower perioperative (30-day) morbidity and mortality.

  • Screening for AAA in patients with any smoking history with one time abdominal US.

The 30-day mortality ranges from 1-2% for endovascular surgical repair and 4-5% for open surgical repair of AAA.  Since this is equal to the annual rupture risk of AAA < 5.5 cm, surgery is recommended for AAA > 5.5 cm or an increase in diameter > 0.5 cm in a 6-month period.  Surgery is also recommended in symptomatic patients, regardless of the size of the aneurysm.  Endovascular repair is being used with increasing frequency for elective treatment of abdominal aortic aneurysms.  Prospective studies demonstrate lower acute morbidity and mortality and fewer late interventions with endovascular repair in experienced hands.  However, long-term survival appears comparable to open repair.

This individual’s aneurysm is considered to be relatively small with a low incidence of spontaneous rupture and does not need referral for repair.  He may have a repeat ultrasound or CT scan in 6 - 12 months to monitor the diameter.