2. • DEFINITION: FOCAL DILATION 1.5X GREATER
DEFINITION: FOCAL DILATION 1.5X GREATER
THAN THE NORMAL DIAMETER OF THE ARTERY
THAN THE NORMAL DIAMETER OF THE ARTERY
(>3 CM)
(>3 CM)
• TRUE ANEURYSM (ALL 3 LAYERS) VS.
TRUE ANEURYSM (ALL 3 LAYERS) VS.
PSEUDOANEURYSM
PSEUDOANEURYSM
• INFRARENAL ABDOMINAL AORTA MOST
INFRARENAL ABDOMINAL AORTA MOST
COMMON LOCATION
COMMON LOCATION
• CAN INVOLVE SUPRARENAL AORTA, ILIAC
CAN INVOLVE SUPRARENAL AORTA, ILIAC
ARTERIES
ARTERIES
8. • PROGRESSIVE ENLARGEMENT LEADING TO RUPTURE,
PROGRESSIVE ENLARGEMENT LEADING TO RUPTURE,
EXSANGUINATION AND DEATH
EXSANGUINATION AND DEATH
• TENTH LEADING CAUSE OF DEATH AMONG MEN >65 YEARS OLD
TENTH LEADING CAUSE OF DEATH AMONG MEN >65 YEARS OLD
• ACTUAL DEATH RATE LIKELY EXCEEDS 15,000 REPORTED DEATHS
ACTUAL DEATH RATE LIKELY EXCEEDS 15,000 REPORTED DEATHS
ANNUALLY, BECAUSE SUDDEN DEATH IS OFTEN MISTAKENLY
ANNUALLY, BECAUSE SUDDEN DEATH IS OFTEN MISTAKENLY
ATTRIBUTED TO MI
ATTRIBUTED TO MI
9. • RUPTURE IS THE GRAVEST AND MOST
RUPTURE IS THE GRAVEST AND MOST
COMMON COMPLICATION
COMMON COMPLICATION
• OTHER COMPLICATIONS INCLUDE:
OTHER COMPLICATIONS INCLUDE:
• PERIPHERAL EMBOLIZATION
PERIPHERAL EMBOLIZATION
• AORTIC THROMBOSIS
AORTIC THROMBOSIS
• FISTULA FORMATION
FISTULA FORMATION
• AORTO-DUODENAL
AORTO-DUODENAL
• AORTO-CAVAL
AORTO-CAVAL
• LOCAL COMPRESSION/MASS EFFECT
LOCAL COMPRESSION/MASS EFFECT
• HYDRONEPHROSIS
HYDRONEPHROSIS
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% MORTALITY
RUPTURED AAA 90% MORTALITY
• ELECTIVE REPAIR <5% MORTALITY
ELECTIVE REPAIR <5% MORTALITY
• EARLY DIAGNOSIS AND ELECTIVE
EARLY DIAGNOSIS AND ELECTIVE
REPAIR CAN REDUCE MORTALITY
REPAIR CAN REDUCE MORTALITY
FROM AAA
FROM AAA
• SCREENING HIGH RISK
SCREENING HIGH RISK
POPULATIONS IS COST EFFECTIVE
POPULATIONS IS COST EFFECTIVE
AND REDUCES AAA-RELATED
AND REDUCES AAA-RELATED
MORTALITY
MORTALITY
38. • LESS INVASIVE PROCEDURE
LESS INVASIVE PROCEDURE
• AAA EXCLUDED FROM CIRCULATION WITH INTRALUMINAL STENT-
AAA EXCLUDED FROM CIRCULATION WITH INTRALUMINAL STENT-
GRAFT
GRAFT
• ENDO HAS LOWER PERIOP MORBIDITY AND MORTALITY RATES BUT MAY
ENDO HAS LOWER PERIOP MORBIDITY AND MORTALITY RATES BUT MAY
BE LESS DURABLE AND REQUIRES MORE FREQUENT FOLLOW-UP THAN
BE LESS DURABLE AND REQUIRES MORE FREQUENT FOLLOW-UP THAN
OPEN REPAIR
OPEN REPAIR
• TYPICALLY RESERVED FOR ELDERLY OR HIGH RISK PATIENT
TYPICALLY RESERVED FOR ELDERLY OR HIGH RISK PATIENT
