Validation and application of intravascular ultrasound in endovascular treatment of abdominal aortic aneurysm

An abdominal aortic aneurysm (AAA) is a localized and permanent dilatation of the aorta that presents a clear danger for the patient because of the risk of rupture. The chance of rupture increases with the size of the aneurysm. Mortality after rupture is high: 60-70% of patients with a ruptured AAA will not reach the hospital alive. Furthermore, surgical treatment of ruptured AAA carries an additional mortality of 45-55%. Because of the poor prognosis of ruptured AAA, prophylactic exclusion of AAA is performed for AAA larger than 5.0 to 5.5 cm in diameter. The standard way of treating AAA is by elective open surgery. In this procedure, the diseased aortic segment is opened after proximal and distal cleaning of the vessel and the contents of the aneurysm are removed. A synthetic prosthesis is placed inside the aneurysm. The proximal and distal ends of the prosthesis are anastomosed via continuous sutures to the normal aorta and/or iliac arteries, after which the aneurysm wall is closed around the prosthesis. Elective surgery itself carries a mortality of 5_7% ,patients aged over 70 years, patients with congestive heart failure, cardiac ischemia, preexistent dysrythmia, renal impairment or pulmonary impairment are known to have an increased mortality.