Suggest treatment for renal abdominal aortic aneurysm

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Posted on Wed, 6 Aug 2014 in Veins and Arteries
Question: I have just been diagnosed with a 3.5 cm infra renal abdominal aortic aneurysm and a 3.5 cm left common iliac artery aneurysm. Is the iliac aneurysm big enough to repair and would they do the AAA at the same time even though it's below 5 cm?
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Answered by Dr. Iven Romic Rommstein 4 hours later
Brief Answer:
Hi and welcome to HCM

Detailed Answer:
Considering your case there is indiaction for surgical repair of both iliac and aortic aneursim with bifurcation graft. Endovasvular tretament is limited in such cases and not redommendable. 3.5 cm is not significant size of aneurism but in cases where there is concomitant iliac anuerism,growth rate of aortal aneurism is much faster then in isolated AAAs. So in your case it is expeceted that AAA wil grow for about 0.5 cm per year so it will reach 5cm sooner or later. There is absolute indication for IAA so it is medically justified to have aorto-iliac repair in one act and not to risk future AAA complications. Wish you good health. feel free to ask.Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Iven Romic Rommstein 4 hours later
Thank you for your reply. As follow up I would ask why endovascular repair is not recommended?
doctor
Answered by Dr. Iven Romic Rommstein 8 hours later
Brief Answer:
hi

Detailed Answer:
EVAR is possible for such pathology but only in highly specialised centres. But studies show increased risk of endoleak, iliac limb occlusion, and aneurysm rupture comparing to open surgery. so by some authors, such large iliac aneursim with small AAA is realtive contraindication for EVAR. Much more propriate for EVAr would be larger AAA with smaller IAA.
Still, it would be the best to consult exeperienced interventional radiologist about this.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Iven Romic Rommstein

General Surgeon

Practicing since :2008

Answered : 13309 Questions

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