Abdominal aortic aneurysm natural history

Abdominal Aortic Aneurysm Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Abdominal Aortic Aneurysm from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Study of Choice
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X-ray
Echocardiography and Ultrasound
CT scan
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Case Studies
Case #1
Abdominal aortic aneurysm natural history On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Abdominal aortic aneurysm natural history
CDC on Abdominal aortic aneurysm natural history
Abdominal aortic aneurysm natural history in the news
Blogs on Abdominal aortic aneurysm natural history
Directions to Hospitals Treating Abdominal aortic aneurysm natural history
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%, with a 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 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:

• Arterial embolism
• 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.