Abdominal Aortic Aneurysm, treatment options and results

Abstract

Introduction: The Abdominal Aortic Aneurysm (AAA) represents the 12 cause of mortality in elderly subjects in USA. It is defined as an aortic dilation more than 3 cm in anterior-posterior or transversal cross-section, that exceeds the limit of 2 standard deviations. The natural evolution of the AAA lead to the rupture, nonetheless, the surgical risk of the procedure can be accepted in the exceeding 5.0-5.5 diameter AAA. Generally, 2 options of surgery can be regarded-Open and Endovascular Aneurysm Repair. Purpose and Objectives: Was to make a meta-analysis focused on the methods from different published studies, contrasting the aneurysm repair results in mid and long term. Material and methods: The study is based on literature review, expressing the outcomes of multicenter randomized clinical trials. There were considered also the screening/diagnostics features, the 30 days mortality and the long term follow up depending on surgical treatment option.Results: The average AAA grow rate is 0.2-0.3 cm/year for an AAA diameter between 3 and 5 cm. Smalls aneurysms are symptomless, clinical signs can install to a large diameter, caused by compression, erosion, trombembolia and the more significant- ruptured AAA. The death rate in an acute rupture varies between 62-94%, depending on the individual risk factors and the situs of rupture. The death rate in scheduled endovascular treatment is under 2%, whereas in open version can arise to 6-7%. The long follow-up shows similar results for the both methods. Conclusions: The screening of risk group reduces the mortality by AAA. The ultrasound monitoring is recommended for a diameter between 3.0 and 5.0 cm, and an interventional treatment is indicated for the aneurysms greater than 50 mm. The application of endovascular technology has no benefit in long-term monitoring.