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Abdominal aortic aneurysm
Background
Overview
Definition
An AAA is a structural disease of the abdominal aorta characterized by a pathological, localized dilatation of > 30 mm or > 50% of the original aortic size.
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Pathophysiology
Multiple environmental factors (including smoking, hypertension, coronary artery disease, and collagen diseases) and genetic factors can induce and accelerate degeneration of the layers of the aortic wall. An inflammatory response in the aortic vessel wall leads to destruction of elastin and collagen in the media and adventitia, loss of smooth muscle cells, thinning of the media, and neovascularization.
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Epidemiology
In the US, the overall prevalence of AAA is estimated at 2,200 persons per 100,000 population.
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Disease course
The majority of AAAs are asymptomatic and are detected as an incidental finding on diagnostic imaging performed for other purposes. AAAs can also present with abdominal pain or complications such as thrombosis, embolization and rupture.
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Prognosis and risk of recurrence
The overall mortality associated with ruptured AAA is approximately 85-90%.
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Guidelines
Key sources
The following summarized guidelines for the evaluation and management of abdominal aortic aneurysm are prepared by our editorial team based on guidelines from the European Society for Vascular Surgery (ESVS 2024,2019), the European Society of Cardiology (ESC 2024,2014), the American Heart Association (AHA/ACC 2022), the U.S. Preventive Services Task Force (USPSTF 2019), the Society for Vascular Surgery (SVS 2018), and ...
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