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Wall lesions of abdominal aortic aneurysms threatening an impending rupture: prognostic evaluations
R Scorza1, M De Monti, J Lazaridis
1Chair of General Surgery, Institute of General and Cardiovascular Surgery, University of Milan, Italy.
Background:
Final events preceding aneurysm rupture are not completely known. The current study relates to incomplete aortic aneurysm wall lesions (i.e. malacia, dark staining and blebs or blisters) as possible sites of aneurysm rupture.
Methods:
162 abdominal aortic aneurysms, resected between 1988 and 1996, have been reviewed and 27 cases of aneurysms presenting wall thickness lesions are reported. The lesions were scheduled by operative reports and compared to ultrasound and CT scans.
Results:
The authors classify aortic aneurysms into three phases, depending on the degree of wall degeneration viz 1. Flawless wall aneurysms. 2. (a-b-c) Aneurysms with intraparietal lesions. 3. Ruptured aneurysms.
Conclusions:
It is concluded that stage 2 aortic aneurysms must be urgently operated on. They carry a high surgical risk and, consequently, higher morbidity and mortality compared with stage 1 aneurysms.