Page 15 - Virtual Vascular Vol 9

The so-called neck of an aneurysm usually refers to the length of normal caliber aorta to
secure an aortic clamp for proximal/ distal control during open surgery, or to provide
adequate landing zone for an endovascular device. Unhealthy wide aortae are not suitable Lateral view
for clamping or anastomosis.

Nomenclature needs to be well-defined and uniform to enable effective professional
communication between vascular specialists.

An infrarenal aortic aneurysm starts ≥ 1cm from the lowest renal artery origin. Coelic axis
A juxtarenal aortic aneurysm starts < 1cm from the lowest renal artery origin. Upper left renal artery

A pararenal aortic aneurysm starts to include the origin of one or more of the renal artery uperior mesenteric artery
origin.

Juxta- and para-renal aortic aneurysms extend cephalad sufficiently closed to the lowest Lower accessory left renal

renal arteries to require inter-renal, supra-renal, or higher cross clamping in open surgery, or artery
require complex EVAR (such as chimney or fenestrated EVAR).

Anteroposterior view

The aneurysm

involved the origin

of the lower left

accessory renal

artery. Therefore by

definition, this is a

pararenal aortic

aneurysm.

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