Paitent is a 61year-old man who underwent AVR due to AR recently. CT scan before AVR showed infrarenal saccular abdominal aortic aneurysm which maximum diameter was 40mm. Saccular part of this aneurysm was almost thrombosed. AVR done successfully.
Patient is asymptomatic and does not have any particular history of systemic infection, auto-immune disease, or connective tissue disease. Pathology of this aneurysm seems to be atherosclerotic.
Open surgery? Stent? Observation?
Follow up seems to be the correct option. Will need a repeat scan in future follow up,
Saccular lesions are frequently considered to be more prone to rupture, recent literature suggests that such is not the case . I agree that a good follow up is the better option.
I agree. I would do a CT scan in 3-6 month. If there is movement I would preferr open surgery in this quite young patient
Follow up with Ultrasound every 6 months is the best approach unless the patient is symptomatic (pain or emboli). Based on size criterion, once it reaches 5 to 5.5 cm then surgery should be considered. Measurements must be done by a technologist with good experience with vascular ultrasound since we are talking about millimeters changes.
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