ABSTRACT
Classification Aortic aneurysms involving the abdominal aorta at or above the level of the renal
arteries have been called suprarenal aortic aneurysms (Fig. 15.1A-C). Depending on the extent of the AAA and the level of renal artery involvement, three different suprarenal aneurysms are distinguished. The term juxtarenal aortic aneurysms is reserved for AAAs without a neck distal to at least one main renal artery orifice, preventing safe infrarenal aortic clamping during surgical repair (Fig. 15.1 A). The more proximal pararenal aneurysms involve the orifices of the renal arteries, but do not extend up to the origin o f the superior mesenteric artery (Fig. 15. IB.). Finally, the term paravisceral aneurysm usually is reserved for those high abdominal aneu rysms that involve the orifices of all visceral and renal arteries (Fig. 15.1C.). The infrarenal aorta may not be involved at all. These are essentially Type IV thoracoabdominal aortic aneurysms, using Crawford classification, since they usu ally require repair through a low thoracoabdominal approach with clamping of the descending thoracic aorta at or just above the level o f the diaphragm.
