Images in vascular medicine. Giant abdominal aortic aneurysm.

Abdominal aortic aneurysm prevalence among men older than 65 years of age has been reported to be as high as 8% in Western countries. A 75-year-old man presented to his general practitioner for evaluation of vague abdominal pain. His medical history was significant for hypertension and an episode of left eye retinal vein occlusion that occurred 15 years before and completely recovered with medical treatment. Clinical examination revealed a large, non-tender, pulsatile mass in the epigastric region. The patient underwent open surgical repair of the abdominal aortic aneurysm the following day (Panel B) with aorto-bifemoral reconstruction using a 16 × 8-mm expanded polytetrafluoroethylene (ePTFE) bifurcated graft. Recovery was uneventful and he was discharged from hospital on postoperative day 12.Open surgical repair is often the only viable treatment because aneurysm size implicates an adverse neck anatomy that makes these AAAs not suitable for endovascular aneurysm repair.