Abdominal Aortic Aneurysm (AAA)

An aneurysm is the abnormal dilatation of a blood vessel to 1.5 – 2 times its normal size. While any blood vessel can potentially form an aneurysm, when this develops within the abdomen it is referred to as an abdominal aortic aneurysm (AAA).

AAA’s cause approximately 15,000 deaths per year and in the United States represents the 13th leading cause of death. It can be caused by multiple factors including smoking, high blood pressure, genetics, trauma and infections. Diagnosis remains problematic as most AAA’s are asymptomatic until rupture resulting in life-threatening hemorrhage or are found incidentally during the workup of other abdominal diseases. While ultrasound represents a good screening test, CT scan is most commonly used for detailed assessments of size and aneurysm extent.

Treatment of AAA's can involve either conventional open vascular repair or placement of an endovascular stent graft to exclude the aneurysm. This is usually recommended when the aneurysm reaches an overall size of 5-5.5cm. Although open surgery remains the gold standard for aneurysm repair, stent graft repair is increasingly evolving into the preferred approach.

Dr. Gabriel is part of a select group of Endovascular Surgeons who has ever placed a fenestrated stent graft for the treatment of AAA's involving the visceral aortic segment. Under the mentorship of Dr. M. David Tilson at the Jane Forbes Clark Surgical Research Laboratories at St. Luke's-Roosevelt Hospital / Columbia University, Dr. Gabriel has also completed extensive research on aneurysms.