Ruptured aneurysms present with severe abdominal or back pain and hypotension/shock. The mortality rate from a ruptured AAA is high: 59 to 83% of patients die before they make it to hospital or undergo surgery. The operative mortality rate for those who make it to surgery is approximately 40%.

CT angiography

• is the gold standard but a high radiation dose

• excellent for pre-operative planning as it accurately delineates the size and shape of the AAA and its relationship to branch arteries and aortic bifurcation

• superior to ultrasound in detecting and sizing common iliac artery aneurysms