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Description: This provides a summary of AAA as a condition including the background, symptoms and signs/clinical presentation, investigations to diagnose the condition and management plan.
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ABDOMINAL AORTIC ANEURYSM (AAA)
AAA = abnormal dilatation of abdominal aorta with a diameter > 3cm
...
§ Back pain or loin pain
§ Abdominal pain ® radiates to back
§ Haemodynamic compromise ® hypotension, tachycardia, collapse
§ Pulsatile abdominal mass
...
-----------------------------------------------------------------------------------------------------------------------------------------------------
Investigation
Screening
§ On NHS for men aged 65 and over
§ Also indicated if patient at greater risk of AA (e
...
FH)
o NICE guidance 2020: consider in women >70 with any one of COPD/vascular
disease/FH/hyperlipidaemia/hypertension/smoker or ex-smoker
§ Consists of abdominal USS
§ <3cm: no follow up required
§ 3-4
...
5-5
...
4cm: urgent 2ww referral to vascular for management
...
AXR
§ Not sensitive test
§ May be routinely ordered in work up of abdominal pain
§ May show: dilated aorta if aortic wall calcification seen
Abdominal USS
§ Simple, non-invasive
§ Readily available and commonly done
...
-----------------------------------------------------------------------------------------------------------------------------------------------------
Management
Elective Management
Conservative
§ Stable AAA not requiring surgical input
§ Advised to follow healthy lifestyle, evaluated for hyperlipidaemia and HTN and treated
§ AAA monitored based on diameter
...
5 cm
o Symptomatic aneurysms
o Asymptomatic >4 cm and grown by >1 cm in 1 year
Endovascular Aneurysm Repair
§ Minimally invasive, utilises endovascular iliofemoral access to deploy aortic graft
§ Can be used elective or emergency
§ Standard EVAR ® consider in unruptured aneurysms who meet above criteria and abdo copathology, anaesthetic risks
or comorbidities that make open surgical repair less desirable
§ Complex EVAR ® if open surgery and complex surgery are both suitable, EVAR should only be used after a detailed
explanation about risks
...
DVLA
Inform DVLA if aneurysm >6cm, stop driving if it is >6
Description: This provides a summary of AAA as a condition including the background, symptoms and signs/clinical presentation, investigations to diagnose the condition and management plan.