An abdominal aortic aneurysm (AAA) is a focal full thickness dilatation of the abdominal aorta, greater than 1.5 times its normal diameter. Although some patients with AAA experience back or abdominal pain, most remain asymptomatic until rupture. The prognosis after AAA rupture is poor. Management strategies for patients with asymptomatic AAAs include risk factor reduction, such as smoking cessation, optimizing antihypertensive treatment, and treating dyslipidemia, as well as surveillance by ultrasound. Currently, aneurysm diameter alone is often used to assess risk of rupture. Once the aneurysm diameter reaches 5.5 cm, the risk of rupture is considered greater than the risk of intervention and elective aneurysm repair is undertaken. There is increasing interest in detecting AAAs early, and national screening programs are now in place. Furthermore, there is increasing research interest in biomarkers, genetics, and functional imaging to improve detection of AAAs at risk of progression and rupture. In this review, we discuss risk factors for AAA rupture, which should be considered during the management process, to advance current deficiencies in management pathways.
From the *Faculty of Medical Sciences, Newcastle University Medical School, Newcastle, UK; †Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundations Trust, Newcastle, UK; and ‡Faculty of Medical Sciences, Institute of Cellular Medicine, Newcastle University, Newcastle, UK.
Disclosure: The authors have no conflict of interest to report.
Correspondence: Vijay Kunadian, MBBS, MD, FRCP, FACC, FESC, Faculty of Medical Sciences, Institute of Cellular Medicine, Newcastle University, 3rd Floor William Leech Building, Newcastle, NE2 4HH, UK. E-mail firstname.lastname@example.org.