Abdominal aortic aneurysm

Abstract

An 86-year-old male was assessed on the day before scheduled urgent endovascular abdominal aortic aneurysm repair (EVAR). An infra-renal abdominal aortic aneurysm (AAA) with a transverse diameter of 6.2 cm was observed by abdominal ultrasound 1 week previously as part of surveillance screening. When assessed 6 months previously, the AAA was measured at 5.6 cm. The patient was offered but declined surgical intervention at that time and elected to continue screening at 6- rather than 12-month intervals. He had a history of known cardiac disease, having had drug-eluting stents placed in his mid-left anterior descending (LAD) obtuse marginal branch of the circumflex artery, and the mid-right coronary artery 3 years prior to presentation. Other comorbidities included paroxysmal atrial fibrillation (last episode 2 years prior to presentation), long-standing hypertension, moderate chronic obstructive pulmonary disease, and mild renal insufficiency (GFR 25 ml/min/1.7m3). He was a 40-pack-year smoker, having quit 5 years prior to this event.