62yo male with infrarenal 50mm AAA and bilateral CIA aneurysms

Background

• STOPBANG 5, ESS 6 (patient attributes elevated ESS to recent stress and poor sleep)
• DASI 8 METS 
• Quit smoking 8 months ago 
• Likely COPD – nil exac/symptoms/LRTI but spirometry in clinic showed FEV1 42%, ratio 0.53

Issues

• Optimisation required or possible?

Discussion

• Ideal not to have open procedure if able given likely moderately severe COPD
• If open procedure would need CPET to further quantify risk and targets for optimization (cardiac or respirartory)
• Conversion from endovascular too open on the day of procedure is rare
• Suitable to proceed to EVAR without further optimization/delay

Plan

• Proceed to EVAR