Surgery | Common Surgical Conditions | Peripheral Vascular Disease Aneurysms AAA

Peripheral Vascular Disease: Aneurysms - AAA
Session Overview
Description
This session will cover the aetiology, diagnosis and management of abdominal aortic aneurysm (AAA).

Learning Objectives
By the end of this session you will be able to:

• Discuss the aetiology of abdominal aortic aneurysm according to relevant research
• Describe the UK AAA screening programme
• Understand factors that affect the management of AAA in the elective setting
• Discuss a framework for immediate management of ruptured AAA
• Describe the complications of open and endovascular approaches for the repair of AAA

An arterial aneurysm is defined as a permanent dilatation of an artery by ≥50%. The normal outer diameter of the abdominal aorta is 2 cm, and hence it is aneurysmal at ≥3 cm. Epidemiological studies of prevalence of AAA vary considerably, but in the UK it is estimated to be 1.3-12.7%[1].

In the UK in 1989, AAA was responsible for 11 000 hospital admissions and 10 000 deaths [2]. Overall prevalence is also increasing rapidly and it is the 13th most common cause of death in the developed world [3-5] (although this may be falling in the UK). Historically the mortality of ruptured aneurysm is around 80-90% [5], compared to around 5% for elective open operation [7].

As a result, screening for AAA has recently been introduced by the UK government and is currently being rolled out nationwide [6] to promote early identification and treatment. Also, in addition to the traditional open operation, endovascular approaches for the treatment of AAA are also becoming more prevalent with good outcomes, particularly in high risk patients [8,9].