Answer
As noted (see Etiology), patients at greatest risk for abdominal aortic aneurysms (AAAs) are those who are older than 65 years and have peripheral atherosclerotic vascular disease. Accordingly, a history of smoking, chronic obstructive pulmonary disease (COPD), and hypertension is often elicited. Less frequent causes include Marfan and Ehlers-Danlos syndromes, collagen vascular diseases, and mycotic aneurysm. Patients who have a first-degree relative with AAA are at increased risk.
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Media Gallery
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Radiograph shows calcification of abdominal aorta. Left wall is clearly depicted and appears aneurysmal; however, right wall overlies spine.
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On radiography, lateral view clearly shows calcification of both walls of abdominal aortic aneurysm, allowing diagnosis to be made with certainty.
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CT demonstrates abdominal aortic aneurysm (AAA). Aneurysm was noted during workup for back pain, and CT was ordered after AAA was identified on radiography. No evidence of rupture is seen.
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Arteriography demonstrates infrarenal abdominal aortic aneurysm. This arteriogram was obtained in preparation for endovascular repair of aneurysm.
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Lateral arteriogram demonstrates infrarenal abdominal aortic aneurysm. Demonstration of superior mesenteric artery, inferior mesenteric artery, and celiac artery on lateral arteriogram is important for complete evaluation of extent of aneurysm.
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Arteriogram after successful endovascular repair of abdominal aortic aneurysm.
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Ultrasonogram from patient with abdominal aortic aneurysm (AAA). This aneurysm was best visualized on transverse or axial image. Patient underwent conventional AAA repair.
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MRI of 77-year-old man with leg pain believed to be secondary to degenerative disk disease. During evaluation, abdominal aortic aneurysm was discovered.
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Age is risk factor for development of aneurysm.
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Inflammation, thinning of media, and marked loss of elastin.
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Pulsatile abdominal mass.
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Aneurysm with retroperitoneal fibrosis and adhesion of duodenum.
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Aortic endoprosthesis (Cook aortic and aortobi-iliac endograft).
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Endoaneurysmorrhaphy
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Endovascular grafts.
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Atheroemboli from small abdominal aortic aneurysms produce livedo reticularis of feet (ie, blue toe syndrome).
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Enhanced spiral CT scans with multiplanar reconstruction and CT angiogram.
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Angiography is used to diagnose renal area. In this instance, endoleak represented continued pressurization of sac.
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