[Surgical indications in abdominal aortic aneurysm in advanced age]

The operative mortality of abdominal aortic aneurysms (AAA) increases with the age of life (0.0% below 65 y., 11.8% above 75 y.). This fact is mainly caused by an increasing number of concomitant diseases. Therefore indication for surgery needs a critical assessment of the risk caused by concomitant diseases vs. risk of rupture of the aneurysm. Recent progress in operative technique and anaesthesia justifies surgery also in high risk patients with impending rupture (large aneurysms, especially with eccentric aortic dilatation). The best approach to reduce emergency interventions for ruptured AAAs (mortality rate: 50%) is an ultrasound screening program for arteriosclerotic patients at risk.