Abdominal Aortic Aneurysm (AAA)

The aorta is the largest and most important artery in the body. It acts like a pipeline (although it’s only as wide as a garden hose) circulating blood from the lungs and heart to the rest of the body including the chest, abdomen, pelvis and lower limbs.

An aneurysm occurs when an artery expands, or dilates, to more than one and a half times its normal size. Abdominal aortic aneurysms occur above the pelvis and below the chest and are more common than thoracic aortic aneurysms.

If not detected and treated in time, an abdominal aortic aneurysms can rupture allowing blood to spill into the body, often having fatal consequences.

Medical sources report that torn abdominal aortic aneurysms are responsible for roughly 4% to 5% of sudden deaths in the United States.

Board-certified vascular surgeons can diagnose and treat abdominal aortic aneurysms in a number of ways, often with minimally invasive surgery.

Risk Factors for an Abdominal Aortic Aneurysm

Although the exact cause of abdominal aortic aneurysms is unknown, caucasian men over the age of 65 are most at risk of developing an abdominal aortic aneurysm, and they are four to six times more prevalent in males than in females.

Other factors that are known to weaken the walls of the aorta, thereby increasing the risk of abdominal aortic aneurysms include:

  • Advanced age (older than 60 years)
  • Smoking – tobacco can seriously impair the lining of the aorta over time
  • Hypertension
  • Family history – patients that have a close relative with a history of an aortic aneurysm have an increased risk of abdominal aortic aneurysms
  • Atherosclerosis – fatty and plaque accumulation can narrow the lining of the arterial walls
  • Previous aneurysms in other arteries in the legs or chest
  • Vasculitis

Lowering your blood pressure may decrease your risk of stroke and heart disease by about 50%.

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Symptoms and Diagnosis of Abdominal Aortic Aneurysm

Abdominal aortic aneurysms usually do not present any symptoms. The majority of them are found during routine physical examinations or on medical image testing for other conditions. Roughly 30% of abdominal aortic aneurysms are found during an ordinary trip to the doctor’s office.

Once a vascular specialist suspects the presence of an abdominal aortic aneurysm he or she may order an ultrasound, CAT scan, or MRI to confirm the diagnosis.

Symptoms will usually be latent until an abdominal aortic aneurysm ruptures. It is only then that patients will experience one or more of the following:

  • Sudden shooting pain in the abdomen or back
  • Pain extending from the belly to the groin, buttocks, and lower limbs
  • Sweatiness and dizziness
  • Nausea and vomiting
  • Quickening pulse
  • Shock or fainting
  • Drop in blood pressure (hypotension)

Treatment of an Abdominal Aortic Aneurysm

The ultimate objective in the treatment of abdominal aortic aneurysms is to prevent the aorta from rupturing. This is typically done through two methods: medical monitoring and surgery. Where an aneurysm is located, its size, and how fast it is growing will all play a role in determining the course of therapy.

Patients with smaller abdominal aortic aneurysms (less than 3 cm in diameter) who are not having any symptoms are typically treated with non-surgical methods including quitting smoking, intense control of high blood pressure, the use of beta-blockers, and regular imaging tests to monitor the progression of the aneurysm.

Larger abdominal aortic aneurysms (5 cm or more in diameter) may require surgical intervention. Abdominal aortic aneurysms are typically repaired through open abdominal surgery or endovascular surgery, depending on the patient’s medical history and the progression of the aneurysm involved.

During open abdominal surgery, the surgeon repairs the injured part of the aorta and inserts a synthetic graft to stabilize it.  Endovascular surgery is less invasive than open surgery; a stent graft attached to a tiny catheter is inserted in the leg and interwoven up to the damaged section of the aorta. The graft strengthens the weakened area of the aorta, helps improve blood flow, and prevents future rupturing.

Prognosis and Prevention

Discovering an abdominal aortic aneurysm before it ruptures is the key factor affecting patient prognosis. Prognosis is generally much better if the abdominal aortic aneurysms is detected before it tears, and if patient and doctor are successful in stabilizing or decreasing the size of the aneurysm.

No medications exist that eliminate the risk of abdominal aortic aneurysms entirely. However, there are a number of strategies individuals can employ to keep their arteries healthy:

  • Controlling blood pressure
  • Quitting smoking
  • Eating a low fat and low cholesterol diet
  • Getting regular exercise
  • Losing weight

If you experience any of the symptoms associated with abdominal aortic aneurysm, you should call 9-1-1 immediately. If you are concerned about developing an abdominal aortic aneurysm, please contact your physician for a consultation.

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