Question:
How are abdominal aortic aneurysms?
Author: H KAnswer:
More frequent in males than females, incidence increases with age, >4 cm affects 1-2% males >50, 90% related to atherosclerosis and most below renal arteries. Prognosis related to size and severity of coexisting CAD and CVD. Risk of rupture increases with size (<5cm 5 year risk 1-2%, 20-40% if >5cm) can form mural thrombus and predispose peripheral embolism May become painful, harbinger of rupture pain and is a medical emergency, acute rupture is life-threat, hypotension requires emergency operation. US sees aneurysm, documents size and screening recommended for age 65-75 years who have smoked. CT contrast and MRI accurate plan endovascular repair, aortography used to evaluate but complication risk and mural thrombi may reduce the size so underestimate the aneurysm Tx op repair, graft, if expanding size, asymptomatic repair if diameter >5.5cm
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