Fusiform or saccular enlargement of aorta ≥ 1.5x normal diameter (> 3 cm in abdominal aorta)
AAA is described by its relationship to renal arteries
Infrarenal: > 1 cm of normal aorta below renal arteries
Juxtarenal: Begins within 1 cm of renal arteries
Suprarenal: Extends above renal arteries
Inflammatory aneurysm: Uninfected AAA with enhancing circumferential inflammatory tissue
5% of AAA
Abdominal pain may mimic rupture
Adjacent structures (e.g., duodenum) involved
Mycotic aneurysm
Misnomer because any infectious agent may be underlying cause
Rare but associated with high mortality
Primary = direct extension from adjacent infection
Secondary = embolic (endocarditis)
Cryptogenic = seeding during septicemia
Salmonella, Staphylococcus aureus, Streptococci
Endovascular aneurysm repair (EVAR): Placement of intravascular endograft to bridge aortoiliac segments and depressurize AAA
Endoleak: Persistent flow of blood outside endograft
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Ultrasonographic Findings
Angiographic Findings
Imaging Recommendations
Nuclear Medicine Findings
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
Jackson RS et al: Comparison of long-term survival after open vs endovascular repair of intact abdominal aortic aneurysm among Medicare beneficiaries. JAMA. 307(15):1621-8, 2012
Sommer WH et al: Time-resolved CT Angiography for the Detection and Classification of Endoleaks. Radiology. 263(3):917-26, 2012
Thawait SK et al: Group B streptococcus mycotic aneurysm of the abdominal aorta: report of a case and review of the literature. Yale J Biol Med. 85(1):97-104, 2012
Walker TG et al: Image optimization during endovascular aneurysm repair. AJR Am J Roentgenol. 198(1):200-6, 2012
Truijers M et al: Endovascular aneurysm repair: state-of-art imaging techniques for preoperative planning and surveillance. J Cardiovasc Surg (Torino). 50(4):423-38, 2009
Lin MP et al: A comparison of computed tomography, magnetic resonance imaging, and digital subtraction angiography findings in the diagnosis of infected aortic aneurysm. J Comput Assist Tomogr. 32(4):616-20, 2008
Blankensteijn JD et al: Two-year outcomes after conventional or endovascular repair of abdominal aortic aneurysms. N Engl J Med. 352(23):2398-405, 2005
Eickhoff JH: Incidence of diagnosis, operation and death from abdominal aortic aneurysms in Danish hospitals: results from a nation-wide survey, 1977-1990. Eur J Surg. 159(11-12):619-23, 1993
LaRoy LL et al: Imaging of abdominal aortic aneurysms. AJR Am J Roentgenol. 152(4):785-92, 1989
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Pathology
Clinical Issues
TERMINOLOGY
Abbreviations
Abdominal aortic aneurysm (AAA)
Definitions
Abdominal aortic aneurysm
Fusiform or saccular enlargement of aorta ≥ 1.5x normal diameter (> 3 cm in abdominal aorta)
AAA is described by its relationship to renal arteries
Infrarenal: > 1 cm of normal aorta below renal arteries
Juxtarenal: Begins within 1 cm of renal arteries
Suprarenal: Extends above renal arteries
Inflammatory aneurysm: Uninfected AAA with enhancing circumferential inflammatory tissue
5% of AAA
Abdominal pain may mimic rupture
Adjacent structures (e.g., duodenum) involved
Mycotic aneurysm
Misnomer because any infectious agent may be underlying cause
Rare but associated with high mortality
Primary = direct extension from adjacent infection
Secondary = embolic (endocarditis)
Cryptogenic = seeding during septicemia
Salmonella, Staphylococcus aureus, Streptococci
Endovascular aneurysm repair (EVAR): Placement of intravascular endograft to bridge aortoiliac segments and depressurize AAA
Endoleak: Persistent flow of blood outside endograft
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Ultrasonographic Findings
Angiographic Findings
Imaging Recommendations
Nuclear Medicine Findings
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
Jackson RS et al: Comparison of long-term survival after open vs endovascular repair of intact abdominal aortic aneurysm among Medicare beneficiaries. JAMA. 307(15):1621-8, 2012
Sommer WH et al: Time-resolved CT Angiography for the Detection and Classification of Endoleaks. Radiology. 263(3):917-26, 2012
Thawait SK et al: Group B streptococcus mycotic aneurysm of the abdominal aorta: report of a case and review of the literature. Yale J Biol Med. 85(1):97-104, 2012
Walker TG et al: Image optimization during endovascular aneurysm repair. AJR Am J Roentgenol. 198(1):200-6, 2012
Truijers M et al: Endovascular aneurysm repair: state-of-art imaging techniques for preoperative planning and surveillance. J Cardiovasc Surg (Torino). 50(4):423-38, 2009
Lin MP et al: A comparison of computed tomography, magnetic resonance imaging, and digital subtraction angiography findings in the diagnosis of infected aortic aneurysm. J Comput Assist Tomogr. 32(4):616-20, 2008
Blankensteijn JD et al: Two-year outcomes after conventional or endovascular repair of abdominal aortic aneurysms. N Engl J Med. 352(23):2398-405, 2005
Eickhoff JH: Incidence of diagnosis, operation and death from abdominal aortic aneurysms in Danish hospitals: results from a nation-wide survey, 1977-1990. Eur J Surg. 159(11-12):619-23, 1993
LaRoy LL et al: Imaging of abdominal aortic aneurysms. AJR Am J Roentgenol. 152(4):785-92, 1989
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