Treatment of Abdominal Aortic Aneurysms: The Role of Endovascular Repair

Rupture of an abdominal aortic aneurysm (AAA) is a significant cause of mortality in the United States. Often asymptomatic, AAA is considered a silent killer because it frequently remains undiagnosed until the time of rupture or the patient's death. Major risk factors, such as smoking, age, sex, race, and family history of aortic aneurysm, affect the formation of AAAs. National screening recommendations and advancements in treatment modalities during the past 20 years have improved morbidity and mortality, especially with the introduction of stent grafts for endovascular repair of the aorta. Endovascular aneurysm repair is less invasive than open surgical repair. This article describes the major risk factors, pathophysiology, and diagnosis of AAA; patient selection for endovascular repair; common adverse events and complications; and perioperative implications for the patient undergoing endovascular repair of an AAA. Knowing the treatment options for patients with AAA who are at high risk for rupture should allow clinicians to determine the best course of immediate and long-term care. Patients who undergo endovascular repair of an AAA should receive lifelong monitoring for complications, especially endoleaks.