Epidemiology and contemporary management of abdominal aortic aneurysms

Abstract

Abdominal aortic aneurysm (AAA) is most commonly defined as a maximal diameter of the abdominal aorta in excess of 3 cm in either anterior-posterior or transverse planes or, alternatively, as a focal dilation ≥ 1.5 times the diameter of the normal adjacent arterial segment. Risk factors for the development of AAA include age > 60, tobacco use, male gender, Caucasian race, and family history of AAA. Aneurysm growth and rupture risk appear to be associated with persistent tobacco use, female gender, and chronic pulmonary disease. The majority of AAAs are asymptomatic and detected incidentally on various imaging studies, including abdominal ultrasound, and computed tomographic angiography. Symptoms associated with AAA may include abdominal or back pain, thromboembolization, atheroembolization, aortic rupture, or development of an arteriovenous or aortoenteric fistula. The Screening Abdominal Aortic Aneurysms Efficiently (SAAAVE) Act provides coverage for a one-time screening abdominal ultrasound at age 65 for men who have smoked at least 100 cigarettes and women who have family history of AAA disease. Medical management is recommended for asymptomatic patients with AAAs < 5 cm in diameter and focuses on modifiable risk factors, including smoking cessation and blood pressure control. Primary indications for intervention in patients with AAA include development of symptoms, rupture, rapid aneurysm growth (> 5 mm/6 months), or presence of a fusiform aneurysm with maximum diameter of 5.5 cm or greater. Intervention for AAA includes conventional open surgical repair and endovascular aortic stent graft repair.

Blood pressure, hypertension and the risk of abdominal aortic aneurysms: a systematic review and meta-analysis of cohort studies

“…Risk factors for the development of AAA include older age, male gender, Caucasian race, family history of the disorder, atherosclerotic disease and smoking [ 9 , 10 ], the latter being considered the primary modifiable risk factor [ 11 ]. Other potential risk factors include diabetes mellitus (DM), which has been shown to be negatively associated with AAA [ 12 ], greater height [ 13 ], and low fruit and vegetable consumption [ 14 ].…”

Bauchaortenaneurysma – Diagnostik und interventionell-radiologische Therapie

“…Primäre Indikationen für eine Intervention bei Patienten mit BAA sind die Entwicklung von Symptomen, eine Ruptur, rasches Aneurysmawachstum (> 5 mm / 6 Monate) oder das Vorhandensein eines fusiformen Aneurysmas ab einem Durchmesser von 5 cm [25], [26].…”

“…Die Indikation zur Behandlung wird anhand des maximalen transversalen Aneurysmadurchmessers (thrombosierte und nicht thrombosierte Anteile) gestellt, wobei die Messung auf einer Centerline erfolgen sollte [3]. Auch ein Aneurysmawachstum im Verlauf kann eine Therapieindikation darstellen [25].…”

Persistence of Intraluminal Thrombus Makes Saccular Aneurysm More Biologically Active than Fusiform in an Experimental Rat Model

“…Intracranial saccular aneurysms are commonly acquired lesions in 1-2% of the population and account for about 80-85% of nontraumatic subarachnoid haemorrhages [4]. Larger abdominal aortic aneurysms above 4 cm are found to be present in roughly 1% of males between 55 and 64 years of age, with a notable rise in prevalence of 2-4% per decade thereafter [5,6]: their prevalence in males has been shown to be higher than in women [7].…”