Abdominal aortic aneurysms part one: Epidemiology, presentation and preoperative considerations

Abstract

An abdominal aortic aneurysm is an irreversible dilatation of the abdominal aorta. The majority of abdominal aortic aneurysms are asymptomatic and identified incidentally while investigating a separate pathology. Others are detected by national screening programmes and some present due to a growth or rupture. Symptomatic or ruptured aneurysms require urgent or emergency repair in patients fit for surgery. Perioperative practitioners should therefore be aware of how patients with abdominal aortic aneurysms present and are investigated, so that they can implement timely management. Guidelines have been recently updated to reflect this. This literature review discusses these recommendations and explores the evidence upon which they are based. The aim of this article is to highlight the important preoperative principles that need to be considered in cases of abdominal aortic aneurysm.

Keywords: Abdominal aortic aneurysm; Cardiovascular disease; Preoperative period; Screening; Vascular surgery.

Figure 1.

Appearance on ultrasound. (I) Transverse view of an AAA. (II) Longitudinal view. In both, a central lumen (a), an area of stable thrombus (b), and areas of dissection or haemorrhage within the thrombus (c) can be seen. Reproduced with permission from Goldstein and Wells (2019).