Abdominal aortic aneurysm: epidemiology, screening, and work-up for repair

Abdominal aortic aneurysm (AAA) is a dilatation greater than 3 cm of the abdominal aorta inferior to the aortic hiatus. In the UK, population screening for AAA is offered to men in the year of their 65th birthday. Men with small AAAs (3.0–5.4 cm) are entered into an ultrasound surveillance program and have their cardiovascular risk factors managed aggressively. An aortic aneurysm that is either symptomatic or has a diameter ≥5.5 cm should be considered for repair to prevent rupture. Repair can be undertaken using either an open surgical or endovascular approach; the decision when to repair an AAA, an by what method, should be a shared decision between the patient and a multidisciplinary clinical team.