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Related Concept Videos

Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
Aneurysm I: Introduction01:30

Aneurysm I: Introduction

An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
Aneurysm II: Clinical Manifestations and Diagnostic Studies01:21

Aneurysm II: Clinical Manifestations and Diagnostic Studies

Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
Aneurysm IV: Nursing Management01:22

Aneurysm IV: Nursing Management

Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...

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Related Experiment Video

Updated: Jun 27, 2026

Microsurgical Creation of Giant Bifurcation Aneurysms in Rabbits for the Evaluation of Endovascular Devices
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EVAR in small versus large aneurysms: does size influence outcome?

Grace J Wang1, Jeffrey P Carpenter

  • 1Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA. Grace.Wang@uphs.upenn.edu

Vascular and Endovascular Surgery
|December 18, 2008
PubMed
Summary

Endovascular aneurysm repair (EVAR) shows similar outcomes for small versus large abdominal aortic aneurysms (AAA). Patient and device selection are key factors in achieving comparable results in AAA treatment.

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Area of Science:

  • Vascular Surgery
  • Medical Devices
  • Aneurysm Treatment

Background:

  • Abdominal aortic aneurysms (AAA) pose significant health risks.
  • Endovascular Aneurysm Repair (EVAR) is a common treatment modality.
  • The impact of aneurysm size on EVAR outcomes requires further investigation.

Purpose of the Study:

  • To compare the outcomes of EVAR for small (<5 cm) versus large (>5 cm) abdominal aortic aneurysms.
  • To assess differences in perioperative complications, mortality, and long-term results.
  • To evaluate the influence of aneurysm neck characteristics on EVAR success.

Main Methods:

  • Analysis of 192 patients from the Power-link trial.
  • Subgroup analysis of small (<5 cm) and large (>5 cm) AAA.
  • Assessment of demographics, perioperative morbidity/mortality, survival, and adverse events including endoleak, migration, and secondary procedures.
  • Comparison of iliac involvement, neck length, and angulation between groups.

Main Results:

  • No significant differences in perioperative morbidity, mortality, or extent of iliac involvement between small and large AAA groups.
  • Small AAA group had longer and less angulated necks.
  • Overall survival, freedom from major adverse events, endoleak, migration, aneurysm-related death, and need for secondary procedures were comparable between groups.

Conclusions:

  • EVAR demonstrates no significant difference in outcomes when comparing small versus large abdominal aortic aneurysms.
  • Controlled patient and device selection are crucial for successful EVAR in both small and large AAA.
  • These findings support the use of EVAR across a range of AAA sizes under appropriate clinical conditions.