- Advanced age
- Tobacco use
- Chronic obstructive pulmonary disease (COPD)
- Male gender
- Atherosclerosis (M/C associated pathology)
- Cystic medial necrosis
- Aortic dissection
- Ehlers-Danlos syndrome
Majority of AAA are identified incidentally during an examination for another unrelated pathology. Most individuals are asymptomatic.
- Non-tender pulsatile abdominal mass
- Abdominal, flank or back pain (seen in enlarging aneurysms).
- Gastrointestinal (GI) or renal manifestations (compression of adjacent viscera)
Ruptured AAA (rAAA):Most patients with a ruptured abdominal aortic aneurysm die before hospital arrival (90% mortality rate)
- Present in shock often with diffuse abdominal pain and distension
Inflammatory AAA:Characterized by intense inflammation, a thickened peel, and adhesions to adjacent structures
- USG (best initial investigation)
- CT, MRA, aortic angiography
Open surgical repair via transabdominal/retroperitoneal approachGOLD STANDARD
- Symptomatic cases (irrespective of size)
- Rapidly growing aneurysms
- Aneurysms > 5.5 cm
Endovascular repair via femoral arterial approach:Recommended in cases not candidates for open surgery: patients with severe heart disease, and/or other comorbidities that preclude open repair.