Abdominal aortic aneurysm (AAA) is defined as a dilation of the aorta with a diameter more than 150% its original length. It is more commonly seen in men, with a ratio of 10:3, and smokers. Additionally, smoking significantly increases the risk of aneurysm rupture, a medical emergency. While other rare etiologies include middle arterial cystic degeneration, syphilis, congenital dysplasia, trauma, and connective tissue diseases, atherosclerosis is the most common etiology for abdominal aortic aneurysm. Risk factors for AAA include smoking, hypertension, advanced age, male, etc…
Most patients with AAA are asymptomatic with the anatomical abnormality discovered on physical examination or by accident. A typical AAA presents laterally with an anterior pulsing swelling with vascular murmur in half of the patients. A few patients have compression symptoms with abdominal fullness being commonly reported.
Abdominal aortic aneurysm repair (EVAR) is a minimally invasive surgery that treats AAA. Indications are similar to those for open surgery. However, the advantage of endovascular procedures is its characteristic small trauma to the patient, which decreases pain and speeds the recovery time as compared with open surgery. In addition, minimally invasive procedures provide a treatment option for those who cannot tolerate traditional surgery or are at high risk for developing serious complications after surgery. With the continued maturation of “fenestration” and “chimney” technology and emergence of branched and multilayered stents, more and more complex AAA once reserved for open surgery are being treated with the endovascular approach. Additionally, for patients with complex tortuous visceral arteries, a hybrid open and endovascular repair can be taken to reduce the overall trauma experienced by the patient.
