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Abdominal Aortic Aneurysm Medical Slides

Abdominal aortic aneurysm affects 4-8% of men over 65, and ruptured AAA carries an overall mortality of 80-90% including pre-hospital deaths. Teaching AAA well requires screening criteria, surveillance intervals, repair thresholds, EVAR anatomy, open repair durability, and rupture protocols in one coherent clinical arc.

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Lecture outline6 slides
01

AAA screening: USPSTF guidelines, risk factors, and ultrasound surveillance intervals

02

Natural history: growth rate, rupture risk by size, and Laplace law

03

Indications for repair: size criteria, rapid growth, symptoms, and sex-specific thresholds

04

EVAR: anatomic suitability, endograft selection, and endoleak classification

05

Open repair: infrarenal clamp technique, graft selection, and perioperative management

06

Ruptured AAA: permissive hypotension, REBOA, and emergency EVAR vs open repair

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FAQ

How should EVAR vs open repair long-term data be taught?

Separate early perioperative benefit from long-term durability. EVAR lowers early mortality in selected patients but requires lifelong surveillance and has higher reintervention risk; open repair has higher upfront physiologic cost but remains more durable for fit patients.

What endoleak classification should be included?

Include Types I-V, emphasizing that Type I and III are high-pressure leaks requiring repair, Type II is common and often observed unless the sac grows, and surveillance imaging is central after EVAR.

How should ruptured AAA emergency management be presented?

Use an algorithm: permissive hypotension, rapid CTA if the patient responds, immediate OR if unstable with known AAA, EVAR when anatomically suitable, and open repair or aortic balloon control when EVAR is unavailable.

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