An abdominal aortic aneurysm (BAA) (synonym: Abdominal aortic aneurysm (AAA); abdominal aortic aneurysm; descending abdominal aortic aneurysm; covered perforated abdominal aortic aneurysm; infrarenal aortic aneurysm; infrarenal abdominal aortic aneurysm; perforated abdominal aortic aneurysm; Rupture of abdominal aorta; rupture of descending abdominal aorta; ruptured abdominal aortic aneurysm; ruptured descending abdominal aortic aneurysm; ruptured infrarenal aortic aneurysm; ICD-10-GM 2019 I71. 3: Aneurysm of the abdominal aorta, ruptured; ICD-10-GM I71.4: Aneurysm of the abdominal aorta, without indication of rupture) refers to a circumscribed pathologic (pathological) bulge of the arterial wall of the infrarenal or suprarenal aorta of ≥ 30 mm, either in the anteroposterior (“anterior to posterior”) or transverse (“transverse”) plane, corresponding to 150% of the “normal” vessel diameter. Smaller bulges are referred to as ectasia.
Aneurysms can occur in any artery in the body. 55% of all aneurysms are in the abdominal aorta.
Definitions of abdominal aortic aneurysm (AAA) by position to renal artery branches:
- Infrarenal AAA: presence of a normal aorta between the superior extent of the aneurysm and the renal artery outlets.
- Juxtarenal AAA: is when the aneurysm extends to but does not include the renal artery outlets.
- Pararenal AAA: extends to the juxtarenal aorta or the base of the superior mesenteric artery and includes the renal artery outlets.
- Suprarenal AAA: involve renal artery outflow but, in addition, extend above the renal artery outflow to the base of the superior mesenteric artery
Sex ratio: males to females is 5-6: 1.
Frequency peak: abdominal aortic aneurysm occurs in smokers and in patients with hypertension (high blood pressure), hyperlipidemia (dyslipidemia) and diabetes mellitus well before the age of 65. Abdominal aortic aneurysm affects up to 10% of male hypertensive patients over 70 years of age.
The prevalence (disease incidence) of abdominal aneurysm is 1-7% of the population over 50 years of age.
The hospital incidence (frequency of new cases) of all abdominal aortic aneurysm was 27.9 and 3.3 per 100 000 population for men and women, respectively.
Course and prognosis: Prognosis depends on the location, size, and growth rate of the aneurysm. With an abdominal aortic aneurysm > 5 cm (men) or > 4.5 cm (women), the risk of rupture increases from 3% to 5% within the following year.
The lethality (mortality related to the total number of people with the disease) of ruptured abdominal aortic aneurysm is circa 80%.Hospital lethality for surgically treated ruptured AAA was 39% in men and 48% in women.
