Protocolo diagnóstico y terapéutico de los aneurismas de la aorta infrarrenal

Abdominal aortic aneurysms (AAA) are a prevalent disease. Ultrasound is the technique of choice for screening and follow-up on asymptomatic AAAs, especially in at-risk groups such as men over 65 years of age or with a family history. The management of unruptured AAA includes controlling cardiovascular risk factors (especially smoking and hypertension). The diameter of the aneurysm is the main risk factor for rupture, so surgical repair is recommended in men with an AAA equal to or greater than 55 mm and women with an AAA equal to or greater than 50 mm or in cases of rapid growth. Open or endovascular surgical repair depends on the patient's comorbidity and aneurysm anatomy. In ruptured AAAs, the diagnosis is made by computed tomography angiography, since ultrasound is not sufficiently accurate to plan the intervention. Rupture entails a high mortality rate (86%–89%) and endovascular treatment is preferable when the anatomy allows it.