What is an abdominal aortic aneurysm?

Abdominal aortic aneurysm should not be called “aneurysm”, it is a local weakness of the abdominal aorta under the action of pathological factors after the expansion and outward expansion, only the appearance of “aneurysm”, but not the usual meaning of the tumor, and therefore a benign disease. There are many causes of abdominal aortic aneurysms, the most common being hypertension and atherosclerosis. Generally speaking, aneurysms larger than 5 cm in diameter have a much higher chance of rupture, which can lead to massive blood loss and death, making them a “time bomb in the patient’s body”. The ratio of men to women with abdominal aortic aneurysms is 5-6:1, with an average age of >60 years. Most people lack clear symptoms and are often found incidentally during physical examinations, ultrasound or CT examinations. The majority of patients only discover a pulsating abdominal mass during physical examination or on their own. Since the mid-1950s, the emergence of artificial blood vessels has made abdominal aortic aneurysm resection and artificial vessel replacement the classic treatment for abdominal aortic aneurysm. The incidence of complications of organ failure after surgery is high. Unfortunately, abdominal aortic aneurysm is a geriatric disease, and the average age of onset of abdominal aortic aneurysm is around 70 years old, and most of these patients have different diseases such as hypertension, coronary heart disease, diabetes mellitus, and pulmonary and renal hypofunction, which makes the surgery much more dangerous. This paradox has plagued vascular surgeons and patients with abdominal aortic aneurysms for more than 40 years since the introduction of abdominal aortic aneurysm resection and artificial vessel replacement, often putting physicians and patients in a dilemma. This embarrassing situation in the surgical treatment of abdominal aortic aneurysms was fundamentally changed after the 1990s by the advent of endoluminal isolation. In the past 20 years, intravascular memory alloy stents, ultra-thin polyester braided artificial vessels, and intravascular catheters have gradually matured and are increasingly used in clinical practice; non-invasive vascular examination techniques such as CT and magnetic resonance angiography have become increasingly accurate; endoluminal repair of abdominal aortic aneurysms is the product of this intellectual progress combined with numerous technological advances. Simply put, endoluminal repair of abdominal aortic aneurysm is to first perform imaging examinations such as CT arteriography on patients with abdominal aortic aneurysm to obtain precise data on the abdominal aortic aneurysm, and then customize a composite made of memory alloy stent and ultra-thin artificial vessel stitches of suitable caliber and length accordingly, and preposition the cold-shrunk memory alloy stent in the catheter at low temperature. When the artificial blood vessel reaches the diseased aorta, the artificial blood vessel is released from the catheter and the memory alloy stent is opened to its original caliber at body temperature to fix the artificial blood vessel on the normal aorta at both ends of the diseased aorta, and the blood flows through the lumen of the artificial blood vessel, and the weak wall of the diseased dilated abdominal aorta is isolated from the high speed and high pressure abdominal aorta. In this way, the blood flow in the abdominal aorta is maintained and the rupture of the abdominal aortic aneurysm is prevented, which means that the abdominal aortic aneurysm is completely cured. In the treatment of abdominal aortic aneurysms with endoluminal isolation, a bifurcated graft (metal stent and artificial vessel composite) is often required because abdominal aortic aneurysms often involve the iliac artery. Compared to traditional open mega-invasive surgery, endoluminal isolation avoids general anesthesia, opening and blocking the aorta, making the procedure much less invasive and requiring only a small 3-cm-long incision at the base of the thigh. The operation time is greatly reduced, and a skilled surgeon can complete a case in 30 minutes. Most patients do not require blood transfusions. The complication rate and mortality rate are also significantly reduced, which gives many patients who cannot tolerate traditional surgery due to their advanced age and multiple coexisting diseases a chance to be cured.