Ruptured Aortic Aneurysm in Women

J.Lassonde, R.Ghali
Maisonneuve-Rosemont  Hospital, University of Montreal

From 1995 to 2006, 29 female patients have been treated for a ruptured AAA.
In these patients, aneurysm diameters were established preop by scan or ultrasound in   23/ 29. Assuming that the diameters of implanted grafts were equivalent to a normal
aortic diameter, ratios (AAA diameter/ graft diameter) were calculated. In group A, i.e. AAA equal or less than 60mms which comprised 10/23 patients (43%), the mean aneurysm diameter was 57 mms, and the presumed normal aortic diameter 14.6mms, for a ratio of 3.9  In group B, the mean aneurysm diameter was 72 mms, and the normal aortic diameter 15 mms, for a ratio of 4.8 . Rupture of AAA is a frequent complication in woman with aneurysm between 50 and 60mms (43%). Operative indication should be based on a ratio greater than 3.5.  Thus, a normal aortic diameter of 12 mms with a distal aneurysm of 4.5 mms is equivalent to a 16 mms aorta with a 56 mms aneurysm. The limit of 55 mms as an indication for AAA is less applicable for small aortic diameter.