Repair of Infrarenal Abdominal Aortic Aneurysms

Abstract

Aneurysms are localized arterial dilations with a propensity toward expansion and rupture. The abdominal aorta is the most common site of aneurysmal disease and shares risk factors with atherosclerosis, including advanced age, male sex, and tobacco use. Rupture is unpredictable, typically unheralded, and most often fatal. The risk of rupture is related to aneurysm size and continued tobacco use. There is no established medical treatment; therefore, prevention of aneurysm-related death relies on aneurysm detection through screening followed by intervention on appropriately selected and prepared individuals. Intervention is typically warranted when the aneurysm has reached a size of 5.5 cm. Treatment is possible through open surgical repair or through endovascular exclusion of the aneurysm. Optimal outcomes rely on careful consideration of the patient’s comorbid disease and life expectancy and the anatomic features of the aneurysm to determine the most appropriate timing and approach to repair. Continued surveillance after intervention is critical to optimizing long-term benefits of repair, especially for those treated through endovascular means. This review contains 33 figures, and 37 references. Key words: abdominal aortic aneurysm, aneurysm, endovascular, endovascular aneurysm repair, repair, rupture, screening