Guidelines for the treatment of abdominal aortic aneurysms: Report of a subcommittee of the Joint Council of the American Association for Vascular Surgery and Society for Vascular Surgery

Abstract

Decision-making in regard to elective repair of abdominal aortic aneurysms (AAA) requires careful assessment of factors that influence rupture risk, operative mortality, and life expectancy. Individualized consideration of these factors in each patient is essential, and the role of patient preference is of increasing importance. It is not possible or appropriate to recommend a single threshold diameter for intervention which can be generalized to all patients. Based upon the best available current evidence, 5.5 cm is the best threshold for repair in an "average" patient. However, subsets of younger, good-risk patients or aneurysms at higher rupture risk may be identified in whom repair at smaller sizes is justified. Conversely, delay in repair until larger diameter may be best for older, higher-risk patients, especially if endovascular repair is not possible. Intervention at diameter <5.5 cm appears indicated in women with AAA. If a patient has suitable anatomy, endovascular repair may be considered, and it is most advantageous for older, higher-risk patients or patients with a hostile abdomen or other technical factors that may complicate standard open repair. With endovascular repair, perioperative morbidity and recovery time are clearly reduced; however, there is a higher reintervention rate, increased surveillance burden, and a small but ongoing risk of AAA rupture. There is no justification at present for different indications for endovascular repair, such as earlier treatment of smaller AAA. Until long-term outcome of endoluminal repair is better defined and results of randomized trials available, the choice between endovascular and open repair will continue to rely heavily on patient preference.

Derivation and Validation of Automated Electronic Search Strategies to Extract Charlson Comorbidities From Electronic Medical Records

“…The latest guidelines advocate surgery when the aneurysm is 5.5 cm or larger. 44 However, we could refine our search strategy to identify variables according to any new definitions by modifying the algorithm for new definitions. Finally, because of the retrospective nature of the study, we only included documented comorbidity in the definite diagnostic criteria.…”

Diretrizes para a cirurgia das doenças da aorta

“…A terapia endovascular pode ser uma alternativa válida em pacientes de alto risco cirúrgico, embora seja uma indicação não consensual 226 .…”

A case of abdominal aortic aneurysm rupture with concurrent nephrolithiasis in a patient with chronic renal failure

“…Anevrizmanın yeri ve kanama miktarına bağlı olarak bilinç kaybı veya şoka yol açar. Yapılan bir çalışmada rüptür riskinin anevrizma çapı ile doğru orantılı olduğu ve 5 cm'nin altındaki çapta rüptür gelişen olguların % 12,8 oranında olduğu belirtilmiştir 9 . Başka çalışmalarda anevrizma çapı ile orantılı olarak yükselen yıllık rüptür riski 4 cm altında %0, 4,5 cm için %1, 5,5 cm için %11 ve 6,5 cm için %26 civarında hesaplanmıştır 2,8 .…”