Aneurysm of the Abdominal Aorta

Katyayini Aribindi, MD, Adrian DaSilva-DeAbreu, MD and Raymundo A. Quintana, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • There are two types of aneurysms: true and false. A true aneurysm involves all three vessel wall layers. False aneurysms or pseudoaneurysms occur when the intimal and medial layers a...

DIAGNOSIS

  • Asymptomatic AAA (majority)

    • USPSTF recommends a one-time screen for an AAA by abdominal ultrasonography for men aged 65 to 75 years with a smoking history (4)[A].

    • Selective screening for AAA...

TREATMENT

GENERAL MEASURES

  • Treat atherosclerotic risk factors: HTN, dyslipidemia, diabetes mellitus, and smoking (4)[A].

  • Smoking was associated with a 0.35 mm/year AAA growth, twice as fast as AAA growt...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Patient Monitoring

  • May do a CT scan 5 years after an open repair for possible late aortic dilatation or pseudoaneurysm (4)[C]

  • Follow-up imaging should be tailored t...

REFERENCES

1 Mussa FF. Screening for abdominal aortic aneurysm. J Vasc Surg.  2015;62(3):774.  [View Abstract]
2 Kuivaniemi H, Ryer EJ, Elmore JR, et al. Understanding the pathogenesis of abdom...

ADDITIONAL READING

  • Aggarwal S, Qamar A, Sharma V, et al. Abdominal aortic aneurysm: a comprehensive review. Exp Clin Cardiol.  2011;16(1):11–15.  [View Abstract]

  • Sweeting MJ, Thompson SG, Brown L...

SEE ALSO

Aortic Dissection; Arteritis, Temporal; Ehlers-Danlos Syndrome; Marfan Syndrome; Polyarteritis Nodosa; Turner Syndrome 

CODES

ICD10

  • I71.4 Abdominal aortic aneurysm, without rupture

  • I71.3 Abdominal aortic aneurysm, ruptured

ICD9

  • 441.4Abdominal aneurysm without mention of rupture

  • 441.3Abdominal aneurysm, ruptured

SNOMED

  • 2339850...

CLINICAL PEARLS

  • Males with a smoking history aged 65 to 75 years should undergo a one-time screening abdominal ultrasound to evaluate for an AAA.

  • Larger AAAs should be screened more often, with electiv...

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