Abdominal aortic aneurysm natural history: Difference between revisions
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When an abdominal aortic aneurysm ruptures, it is a true medical emergency. Aortic dissection occurs when the innermost lining of the artery tears and blood leaks into the wall of the artery. This most commonly occurs in the aorta within the chest. | When an abdominal aortic aneurysm ruptures, it is a true medical emergency. Aortic dissection occurs when the innermost lining of the artery tears and blood leaks into the wall of the artery. This most commonly occurs in the aorta within the chest. | ||
Complications include: | Complications include: | ||
*Acute aortic occlusion | |||
*Aortocaval or aortoduodenal [[fistulae]] | |||
*[[Arterial embolism]] | *[[Arterial embolism]] | ||
*[[Disseminated intravascular coagulation]] | |||
*[[Heart attack]] | *[[Heart attack]] | ||
*[[Hypovolemic shock]] | *[[Hypovolemic shock]] | ||
Revision as of 01:10, 28 October 2012
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Abdominal Aortic Aneurysm Microchapters |
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Differentiating Abdominal Aortic Aneurysm from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Abdominal aortic aneurysm natural history On the Web |
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Directions to Hospitals Treating Abdominal aortic aneurysm natural history |
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Risk calculators and risk factors for Abdominal aortic aneurysm natural history |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
An aortic aneurysm can progress to a ruptured abdominal aortic aneurysm, which is a medical emergency associated with an extremely high mortality. Serious complications can also occur as a result of an aortic dissection, such as myocardial infarction, shock, stroke, kidney failure, and arterial emboli. A ruptured AAA carries an overall mortality rate approaching 75%, which is much higher than the mortality rate of 2-6% in those patients who underwent elective surgical repair. Approximately 16% of large AAAs (diameter >5.5 cm) rupture, causing 9,000 AAA-related deaths in the United States per year [1] Several studies have shown that screening can drastically reduce the aneurysm rupture rate by 45-49% for men older than 60, and reduce AAA-related mortality by 21-68%.
Natural History
Abdominal aortic aneurysms expand slowly over time. It is for this reason ultrasound surveillance is recommended. If the rate of expansion exceeds 1 cm per year, this is an indication for surgery.
Complications
When an abdominal aortic aneurysm ruptures, it is a true medical emergency. Aortic dissection occurs when the innermost lining of the artery tears and blood leaks into the wall of the artery. This most commonly occurs in the aorta within the chest. Complications include:
- Acute aortic occlusion
- Aortocaval or aortoduodenal fistulae
- Arterial embolism
- Disseminated intravascular coagulation
- Heart attack
- Hypovolemic shock
- Kidney failure
- Stroke
Prognosis
Elective Surgery in the Absence of Abdominal Aortic Aneurysm Rupture
The outcome is usually good if an experienced surgeon repairs the aneurysm before it ruptures.
Emergency Surgery in the Setting of Abdominal Aortic Aneurysm Rupture
Rupture of an abdominal aortic aneurysm is associated with a 60% to 90% mortality before the patient reaches hospital. It is associated with a 30% to 80% operative mortality among those patients who survive long enough to undergo surgery.
References
- ↑ Gillum RF (1995). "Epidemiology of aortic aneurysm in the United States". Journal of Clinical Epidemiology. 48 (11): 1289–98. PMID 7490591. Retrieved 2012-10-27. Unknown parameter
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