Abdominal Aortic Aneurysms

Abstract

Abdominal aortic aneurysms (AAAs) have a prevalence of 4–7% in adults aged 65–80 years old, with the prevalence increasing with increasing age. AAA is most prevalent in white men with the ratio of men to women presenting with AAA reported to be 5:1. AAA rupture is a major complication in this patient population with a mortality rate as high as 90%. Most patients die before reaching the hospital. Elective repair is typically recommended with aneurysm diameter of 5 cm or greater, in symptomatic patients and in patients with rapidly expanding aneurysms. The mortality of elective repairs is reported to be significantly lower (4–6%) than that of emergent repairs (50–60%). Dr. Charles Dotter first proposed endograft repair in 1969. The first series of endovascular abdominal aortic aneurysm repair was not published until 1991. In this chapter, we discuss evaluating patients of abdominal aortic aneurysms and review the indications and technical considerations of performing an endovascular abdominal aortic aneurysm repair (EVAR).