Abdominal aortic aneurysms (AAAs) are characterized by dilation of the abdominal aorta at least 1.5 times the normal diameter of the average adult, which is approximately 2 cm in men and 1.5 cm in women. Although the incidence is relatively low, this disease can be devastating, with AAAs accounting for roughly 15,000 deaths annually in the United States. This review covers the focused history and physical examination of a patient with a known AAA, evaluation of small and large AAAs, and surveillance of AAAs. Tables highlight recommendations for best medical management of small AAAs during the surveillance period, and information on nicotine replacement and nonnicotinic pharmacotherapy. Figures show a calcific rim consistent with the atherosclerotic rim of an AAA, a small AAA, a small inflammatory AAA, and age-adjusted effects of lifestyle characteristics and risk of AAA. An algorithm provides an approach to nonoperative management of stable AAAs.
This review contains 5 figures, 3 tables, and 86 references.