Abdominal Aortic Aneurysm

The aorta is the largest artery in your body with the important job to carry oxygen-rich blood from your heart to your vital organs and extremities (arms/legs).  An aneurysm is an enlargement of an artery wall and an abdominal aortic aneurysm (AAA) happens when the wall of the aorta becomes weak and starts to bulge.

An AAA is a very serious condition since the walls of the aorta may continue to enlarge and, if left untreated, could rupture.  The larger the size of the aneurysm, the higher the risk for rupture, possibly causing severe internal bleeding and, potentially death.

Patients with abdominal aortic aneurysms are more likely to develop plaque formation with the aneurysm. These formations can break loose and travel to other areas of the body and block an artery.  Blocked arteries, if left untreated, can mean severe limb pain or the eventual loss of limb.

Each year, nearly 200,000 people in the U.S. are diagnosed with an abdominal aortic aneurysm.  If not detected and treated in a timely manner, roughly 15,000 of those cases may be severe enough to cause death. Unfortunately, a majority of patients who suffer from a ruptured AAA were not even aware that they had an aneurysm until it ruptured.

RISK FACTORS FOR AAA

While the exact causes of an abdominal aortic aneurysm are not fully understood, research suggests the following risk factors may increase your risk for developing the condition:

• Family history of AAA

• Smoking

• High blood pressure

• Age (over 60)

• Higher incidence in male population

• History of vascular disease (hardening of the arteries)

• Chronic lung disease

SYMPTOMS OF AAA

While most patients with aneurysms do not experience any symptoms, some patients may experience the following:

• Pulsation in the abdomen

• Unexplained, severe pain in the abdomen or lower back

• Pain, discoloration, or sores on feet (this is an uncommon symptom)

Symptoms of a ruptured aneurysm may include severe pain in the abdomen or back, as well as shock-like symptoms.  Complications from a ruptured AAA may include heart attack, stroke, arterial embolism, kidney failure, and death.

DIAGNOSIS OF AAA

Because of the lack of obvious symptoms, many aneurysms are detected when a patient is being tested for unrelated reasons. An ultrasound and/or CAT scans is then used to confirm the presence and measure the aneurysm size.  A treatment plan is created based on the size, location, and shape of the aneurysm.

TREATMENT OF AAA

Your healthcare provider will develop the best treatment option for you based on your medical history and the severity of the condition.  Small aneurysms (less than 5 cm in diameter) are usually observed conservatively to determine the rate of growth.  A vascular specialist will consider the surgical repair of an aneurysm if the following conditions are present:

• Greater than 5 cm in diameter

• Greater than two times the size of a normal aorta

• Aneurysm size increases at a rapid pace

• Patient experiences symptoms

The surgical repair options for abdominal aortic aneurysms include:

• Endovascular Stent Graft:  During this procedure, a vascular surgeon places a stent inside the aneurysm through a small incision in the groin.  The blood flows through the stent and the aneurysm shrinks around it.  (Not everyone is a candidate for endovascular repair since the size, shape, and location of the aneurysm needs to be taken into consideration.)

• Open, Surgical Repair:  If the aneurysm is not suitable for endovascular repair, a vascular surgeon will replace the diseased segment of the aorta with a bypass graft using an open abdominal incision.

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