Optimal Management of Abdominal Aortic Aneurysm and Regular Surveillance.
10.3904/kjm.2015.89.4.398
- Author:
Jong Young LEE
1
;
Seung Whan LEE
Author Information
1. Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
- Publication Type:Review
- Keywords:
Aortic aneurysm;
Abdominal
- MeSH:
Aneurysm;
Aorta;
Aorta, Abdominal;
Aortic Aneurysm;
Aortic Aneurysm, Abdominal*;
Appointments and Schedules;
Humans;
Life Expectancy;
Mortality;
Renal Artery;
Risk Factors;
Rupture;
Ultrasonography
- From:Korean Journal of Medicine
2015;89(4):398-403
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
An abdominal aorta with a maximal diameter of > 3.0 cm is considered aneurysmal. Abdominal aortic aneurysm (AAA) most often affects the segment of aorta between the renal arteries. Patients with aneurysms under observation should undergo periodic imaging to assess for aortic expansion, but the optimal surveillance schedule has not been defined clearly. Generally, surveillance is every 6 to 12 months by ultrasound or computed tomography for medium-sized aneurysms (4.0 to 5.4 cm in diameter), but less frequent intervals (every 2 to 3 years) are recommended for smaller aneurysms. The primary goals of aneurysm repair are to prevent rupture while minimizing morbidity and mortality associated with repair. Two methods of aneurysm repair are currently available: traditional open surgery and endovascular aneurysm repair (EVAR). In randomized trials, EVAR is associated with lower perioperative morbidity and mortality compared with open AAA repair but does not completely eliminate the future risk of AAA rupture, whereas open repair is associated with higher perioperative morbidity and mortality than EVAR but provides a more definitive repair. Physicians must choose an individualized approach for AAA repair, taking into account the patient's age, aortic anatomy, life expectancy, and risk factors for perioperative morbidity and mortality.
