Abstract
Large, symptomatic and ruptured abdominal aortic aneurysms are usually treated surgically if patients are deemed fit enough. This may be achieved through endovascular or open surgical repair. The type of treatment that a patient receives is dependant on many factors, such as the rupture status of the aneurysm. Each approach is also associated with different risks and postoperative complications. Multiple guidelines exist to inform the surgical management of abdominal aortic aneurysms. This literature review combines these recommendations and explores the evidence upon which they are based. In addition, it highlights the key perioperative considerations that need to be considered in cases of unruptured and ruptured abdominal aortic aneurysms.
Highlights
An abdominal aortic aneurysm (AAA) is defined as an irreversible dilatation of the abdominal aorta to a diameter greater than 3.0 cm or 1.5 times its normal anteroposterior diameter (NICE 2020)
Due to the poor outcomes associated with ruptured abdominal aortic aneurysm (rAAA), the National Institute for Health and Care Excellence (NICE), European Society for Vascular Surgery (ESVS) and the Society for Vascular Surgery (SVS) have published comprehensive guidelines on the surgical management and surveillance of patients with AAAs (Chaikof et al 2018, NICE 2020, Wanhainen et al 2019). This review explores these recommendations, highlighting the key perioperative factors that need to be considered in the care of these patients
4.7%), which continues for the first six months (4% vs. 7%) (Patel et al 2016, Stather et al 2013). This early advantage is corroborated by more recent data, in which the in-hospital mortality rate for infra-renal AAAs is reported as 0.4% after endovascular aneurysm repair (EVAR), compared with 3.2% after open surgical repair (OSR) (National Vascular Registry 2019)
Summary
An abdominal aortic aneurysm (AAA) is defined as an irreversible dilatation of the abdominal aorta to a diameter greater than 3.0 cm or 1.5 times its normal anteroposterior diameter (NICE 2020). Due to the poor outcomes associated with rAAAs, the National Institute for Health and Care Excellence (NICE), European Society for Vascular Surgery (ESVS) and the Society for Vascular Surgery (SVS) have published comprehensive guidelines on the surgical management and surveillance of patients with AAAs (Chaikof et al 2018, NICE 2020, Wanhainen et al 2019). This review explores these recommendations, highlighting the key perioperative factors that need to be considered in the care of these patients
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