TAILIEUCHUNG - Ebook ABC arterial and venous disease (2/E): Part 2

Part 2 book “ABC arterial and venous disease” has contents: Abdominal aortic aneurysms, secondary prevention of peripheral arterial disease, vasculitis, varicose veins, venous thromboembolic disease, the ulcerated lower limb, venous ulceration, and other contents. | CHAPTER 8 Abdominal Aortic Aneurysms Matthew J Bown, Guy Fishwick, Robert D Sayers OVE R VIEW • The infrarenal abdominal aorta is the most common site for arterial aneurysm. • Abdominal aortic aneurysms (AAAs) cause ∼10 000 deaths per annum in England and Wales. The overall community mortality from ruptured AAAs is nearly 90%. • Smoking is the most significant risk factor for AAA. The prevalence of AAA is nearly 6-fold greater in males than in females. • Despite convincing studies proving the benefits of ultrasound screening for AAA, no national screening programme exists in the UK at present. • The peri-operative mortality of endovascular repair is one-third of that of open repair, and this benefit in reduced risk from AAA related death is borne out long-term. Introduction The infrarenal abdominal aorta is the most common site for arterial aneurysms, the vast majority of which are fusiform in shape (Figure ). Abdominal aortic aneurysms (AAAs) cause ∼10 000 deaths per annum in England and Wales, and in 2003 were the eighth most common cause of death. In addition, deaths due to ruptured AAAs have nearly doubled over recent years (Figure ) and this increase has been largely amongst the elderly (≥80 years old) population. Definition The definition of aneurysmal arterial dilatation is an increase in vessel diameter of ≥50% in relation to an adjacent normal arterial segment. For practical purposes (in the case of the abdominal aorta) a measurement of >3 cm in any axial diameter is taken to be diagnostic for AAA. Normal infrarenal diameter is 2– cm in males and – cm in females. ABC of Arterial & Venous Disease, 2nd edn. Edited by R. Donnelly and N. London. © 2009 Blackwell Publishing Ltd. 9781405178891. 44 Prevalence In population screening studies of men, estimates for prevalence of AAAs >3 cm in size vary from 5 to . The prevalence of AAA is lower in women at ∼. AAA is a disease of Western nations; they are extremely rare in Asian .

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