A complete blood count with differential is used to assess transfusion requirements and the possibility of infection. A metabolic panel (including kidney and liver function tests) is indicated for ascertaining the integrity of renal and hepatic function and thus help assess operative risk and guide postoperative management. Blood must be typed and crossmatched to prepare for the possibility of transfusion, including clotting factors and platelets.
Because synthetic material is used in the intervention, any potential foci of infection should be assessed and eliminated preoperatively with the aid of urinalysis.
The preoperative workup should also include assessment of pulmonary function to help evaluate operative risk and determine postoperative care. Patients who can climb a flight of stairs without excessive shortness of breath generally do well. If the patient’s pulmonary status is in question, blood gas measurement and pulmonary function tests are helpful.
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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.
