ABSTRACT
Abdominal aortic aneurysms are a common cause of sudden death in old age. In an unselected population of men over the age of 60 years, about 1.5% will have an aneurysm of the abdominal aorta on ultrasound screening. In selected groups (those with a history of hypertension, coronary, cerebral or peripheral vascular disease), men over 60 will have an incidence of 7-8%. Women have a much lower incidence: approximately 1-2% in similarly selected groups. Most (95%) abdominal aortic aneurysms are infra-renal in origin and hence can be considered for both endovascular and open repair. By contrast, those with a supra-renal aortic aneurysm will be unsuitable for any current endovascular device, with open surgery carrying a higher morbidity and mortality than infra-renal surgery. In the elderly patient (>75 years) with a supra-renal aneurysm, it may be wise to monitor with serial ultrasound scans at six-monthly intervals with aneurysms of less than 6 cm diameter.
