Aneurysm is a pathology of the specialty of angiology and vascular surgery. In case of rupture of abdominal aortic aneurysm, mortality is close to 90%.
An aneurysm is understood as the localized permanent dilatation of an artery, with an increase in diameter of more than 50% compared to the normal diameter. The most common aneurysm is the infrarenal abdominal aortic aneurysm. It is more common in men, with an approximate prevalence of 3% in men over 50 years of age.
Aneurysms are formed by degeneration of the arterial wall. Among the factors that favor their appearance are: age, smoking and family or genetic predisposition.
During their development they do not usually generate alarming symptoms. The most feared risk is rupture. Ruptured abdominal aortic aneurysms have a mortality rate of 90%. Only when they begin to complicate, they manifest as pain, shock, … which may correspond to the onset of a rupture that leads to death quickly. Although it is very difficult to calculate exactly, some of the so-called ‘sudden deaths’ correspond to ruptures of abdominal aortic aneurysms (AAA).
As aneurysms do not show their face until they start to become complicated, it is advisable to diagnose them early before it is too late. For this reason, in some countries AAA early diagnosis programs are applied in at-risk population groups. That is, in men over 65 years of age, smokers or with a family history of AAA.
Aneurysms that are at risk of rupture should be treated preventively and programmed before they irreversibly rupture. We have two surgical modalities to repair AAA. Conventional surgery aims to replace the aneurysmal artery segment with a vascular prosthesis through surgical exposure of the aorta.
The other modality is endovascular treatment, which aims to exclude the AAA by implanting an endoluminal prosthesis applied with a catheterization technique. Currently, 55-75% of AAAs are repaired with endovascular techniques. Fortunately, aneurysms in other locations can now be treated with this novel technique.