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Repair of Abdominal Aortic Aneurysms: JACC Focus Seminar, Part 1

Sara E Hensley1, Gilbert R Upchurch1

  • 1Department of Surgery, University of Florida College of Medicine, Gainesville, Florida, USA.

Journal of the American College of Cardiology
|August 18, 2022
PubMed

Insights

Abdominal aortic aneurysms (AAAs) affect over a million Americans. Management includes surveillance, medical therapy for asymptomatic cases, and surgical repair for larger aneurysms.

Area of Science:

  • Vascular Surgery
  • Cardiovascular Medicine

Background:

  • Abdominal aortic aneurysms (AAAs) are a significant health concern, affecting over 1 million individuals in the U.S.
  • Defined by an aortic diameter exceeding 3 cm, AAAs have identifiable risk factors including male sex, smoking, and age.

Purpose of the Study:

  • To outline current recommendations for the diagnosis and management of abdominal aortic aneurysms.
  • To provide guidance on surveillance, medical management, and surgical intervention thresholds for AAAs.

Main Methods:

  • Review of current clinical guidelines and literature on AAA management.
  • Ultrasonography for surveillance of known AAAs.
  • Assessment of risk factors and patient characteristics influencing management decisions.

Main Results:

  • Regular ultrasonography surveillance is recommended for patients with known AAAs.
  • Medical management, focusing on smoking cessation and blood pressure control, is advised for asymptomatic patients below intervention thresholds.
  • Elective repair is generally recommended for men with AAAs >5.5 cm and women with AAAs >5.0 cm.

Conclusions:

  • Effective management of AAAs involves a combination of surveillance, risk factor modification, and timely intervention.
  • Both endovascular and open surgical repair options offer good long-term outcomes for eligible patients.
  • Adherence to established guidelines ensures optimal patient care and reduces AAA-related morbidity and mortality.

Keywords:
AAAEVARabdominal aortic aneurysmaorta pathologyendovascular aortic repair

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