abdominal aortic aneurysm (redirected from Dissecting AAA)

abdominal aortic aneurysm (AAA),

abnormal dilatation of the abdominal aorta, usually in an area of severe atherosclerosis.

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abdominal aortic aneurysm

A focal aortic dilation of ≥ 50% ↑ in diameter, accompanied by distension and weakened aortic wall Epidemiology Incidence is rising 12/10⁵–1951; 36/10⁵–1980; ♂:♀ ratio 2:1; results in 15,000 deaths/yr–US 1988, population ± 230 x 106 Clinical Sudden, severe abdominal pain radiating to back Diagnosis 100% accuracy with Ultrasonography–Cons Difficult in obese subjects, or with excess bowel gas, periaortic disease, technique does not document proximal or distal ends of aneurysm for surgery Treatment ≥ 5 cm in diameter AAAs should be repaired; therapy of smaller AAAs is controversial Contraindications to elective reconstruction MI in last 6 months, intractable angina or CHF, severe pulmonary insufficiency with dyspnea at rest, severe renal insufficiency, life expectancy of ≤ 2 yrs Prognosis Treatment mortality is ± 6%; 25--40% of untreated cases rupture in 5 yrs, with a 90% mortality if ≥ 5 cm