Q: My 59 years old mother has high blood pressure for the last 31 years and diabetes for 7 years and is now suffering from an aneurysm in the abdominal aorta. The CT scan reports fusiform aneurysmal dilatation of infra renal abdominal aorta extending up to the aortic bifurcation, calcifications were seen in the wall of the aneurysm. The aneurysm measures 5 cm in width and 8.1 cm in length. The impressions are of fusiform aneurysm of infra-renal segment of abdomen aorta, 85-90% of stenosis of origin of right renal artery, 90-95% stenosis of origin of left renal artery, 40% of stenosis of origin of celiac artery. What are the treatmentoptions?

A:Your mother has a condition called abdominal aortic aneurysm, which is significantly enlarged in size. It would require a surgical intervention, which involves either open surgical repair or placement of an endovascular graft or stent. Open repair is a higher risk procedure over a short term while stent procedure is associated with a lower morbidity and mortality especially during and immediate following the surgical procedure and is relatively cheap. Choice of intervention would depend on the presence of risk factors including degree of blood pressure control, evidence of underlying kidney disease, and age of the patient (older you are, more riskier it becomes). Stent placement approach is preferred in high-risk patients. In addition, initial study of anatomy of the affected vessels would also be needed to arrive at the decision concerning preferred surgical approach. Your mother also has a significant blockage of both the kidney arteries, which also may require intervention to relieve the blockage preferably by a stent placement. It is advised that she consult a vascular surgeon.