Abdominal aortic aneurysms
Thomas Kelley and colleagues discuss the surgical options for treating this common condition
Since the early 1990s the management of abdominal aortic aneurysms (AAAs) has changed: the traditional repair of large aortic aneurysms by open surgery competes with endovascular aneurysm repair. With the imminent introduction of a UK screening programme for AAA in men aged 65-79 it is vital that we understand AAAs and the interventions available.
An AAA is a focal dilation of greater than 150% of the normal aortic diameter or an infrarenal aneurysm greater than 3 cm.1 AAAs are common among people older than 65 and are seen more often in men, with a male to female ratio of 6:1 in people younger than 80.2 AAAs are found in about 5-10% of men aged 65-79 years.3 Smoking is the single biggest risk factor for the development and growth of AAAs. The disease process has also been associated with hypertension, dyslipidaemia, age, and family history, but the extent of involvement of