Aortic aneurysms are of different types as different ones are the types of treatment available to us. Following the advent of endovascular surgery, perioperative mortality has been significantly reduced, but open surgery remains the first choice under some occurrences. The purpose of this chapter is to try to clarify the dichotomy between open and endovascular aortic aneurysms in the several types of aortic aneurysms, highlighting the indications and complications to guide to the best therapeutic choice.

We report a case of fusiform type of abdominal aortic aneurysm which was found during the routine dissection of a cadaver, done for teaching the undergraduate medical students. The aneurysm was seen unruptured and positioned below the renal arteries, just above the aortic bifurcation. This study illustrates the microscopic and surgical anatomy of the aneurysm with added literature review and clinical implications. We believe that the knowledge of this vascular pathology will be enlightening for broad specialties of medicine and medical science researchers alike.

Endovascular grafting of abdominal aortic aneurysms should be offered only to those patients with suitable anatomy. This is especially true at the level of the proximal aortic neck in order to secure long-term proximal fixation. Aortoiliac anatomy is easy to understand conceptually, however, it is difficult to define and measure quantitatively. In this article, we discuss the use of three dimensional computed tomographic angiography to determine aneurysm morphology and select patients for endovascular repair. Specifically, we apply our methods to define and measure angulation of the aorta and iliac arteries. The anatomic definition of the angulation of the proximal aortic neck is emphasized.