Endovascular aneurysm repair

Abstract

Endovascular repair of ruptured abdominal aortic aneurysm (AAA) is restricted to facilities with a defined program for emergency endovascular surgery. The reasons for the development of AAA are not clearly apparent. Advanced age, male gender, and smoking are important risk factors for AAA. For diagnostic purposes, ultrasound is considered a safe, reliable, and inexpensive initial imaging test for confirming AAA in asymptomatic patients who are suspected of having AAA on physical exam. Most patients are asymptomatic, and AAA is detected as an incidental finding on a routine imaging study performed for other medical reasons, or as part of the screening exam. The chapter describes some of the main indications for treatment of AAA. Treatment is usually started due to the potential for increased sac pressure and rupture. Intravascular ultrasound (IVUS) can be used to evaluate the anatomy prior to treatment and assess the endograft after placement. Endovascular treatment entails embolization by a transarterial method or direct translumbar puncture.