Abdominal aortic aneurysm: diagnosis and management. National Institute for Health and Care Excellence. If the patient has a symptomatic, unruptured AAA, urgent surgical repair should be considered regardless of AAA diameter because development of new or worsening pain may herald AAA expansion and impending rupture. Editor's choice - European Society for Vascular Surgery (ESVS) 2019 clinical practice guidelines on the management of abdominal aorto-iliac artery aneurysms.
Wanhainen A, Verzini F, Van Herzeele I, et al. Use blood and blood products, if available, with a suggested ratio of fresh frozen plasma/red blood cells close to 1:1. Management and transfer of patients with a diagnosis of ruptured abdominal aortic aneurysm to a specialist vascular centre. However, the Royal College of Emergency Medicine recommends a higher target SBP of 90 to 120 mmHg, which may be used by the emergency department team to ensure adequate perfusion while waiting for input from a regional vascular service. In practice, this target SBP is a good approach if definitive surgical repair is imminent. The European Society for Vascular Surgery recommends aiming for a target systolic blood pressure (SBP) of 70 to 90 mmHg. If the patient has a ruptured AAA, initiate hypotensive resuscitation (permissive hypotension) if they are conscious. ĭo not delay diagnosis and management of a ruptured AAA while waiting for the results of imaging. Discuss the patient immediately with a regional vascular service to consider transfer for urgent surgical repair if they have suspected ruptured or symptomatic AAA and bedside aortic ultrasound has confirmed the presence of an AAA or is non-diagnostic or not available.
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