Management of abdominal aortic aneurysms

Rupture of an abdominal aortic aneurysm (AAA) remains a common vascular cat astrophe in all emergency departments. Currently, the natural history of AA As indicates that risk of rupture increases considerably when the aneurysm is greater than 5 cm in diameter. Appropriate management of aneurysms is el ective repair for patients with a good operative risk whose aneurysm is bet ween 5 and 6 cm. For patients with a serious medical comorbidity, the thres hold for AAA repair is usually 6 cm. Surgical management is generally safe with extraordinarily durable results. Another current option is an investig ational endovascular stent graft, but the long-term outcome for these new d evices remains unknown. In addition, optimal medical management should incl ude careful control of hypertension and smoking cessation. The current prog nosis for healthy patients who undergo elective aneurysm repair is excellen t.