Aneurysm Disease

Abdominal aeortic aneurysmWhat is an abdominal aortic aneurysm?

The abdominal aorta is the largest artery (blood vessel) in your abdomen that supplies blood from your heart to your abdomen, pelvis and legs. An abdominal aortic aneurysm is a ballooning or bulging of the aorta that has developed over time. Pressure from blood flowing through your abdominal aorta can cause a weakened part of the aorta to bulge, much like a balloon.

Clots and debris form inside the aneurysm. These clots can travel to your legs and cause blockages and pain or even more serious problems, such as limb loss.

When the weak point bursts or ruptures, severe internal bleeding occurs, which can lead to shock and death.

Abdominal aortic aneurysm symptoms

Abdominal aortic aneurysms (AAA) develop slowly over several years and are often hard to detect during a routine medical examination. If an abdominal aortic aneurysm is detected, it is often found during a routine medical test such as an X-ray or an ultrasound. Most people with AAA do not experience any symptoms. If you develop symptoms, you may experience one or more of the following:
  • Severe abdominal or lower back pain. The pain may also be felt in your groin, buttocks or legs.
  • Rapid heartbeat
  • Pain, discoloration, or a sore may develop on your feet because of material shed from the aneurysm
  • Abdominal rigidity
  • Clammy skin
  • Nausea and vomiting
A ruptured aneurysm is a life-threatening situation. Seek medical attention immediately.

Abdominal aortic aneurysm causes

Although an abdominal aortic aneurysm can develop in anyone, males over the age of 60 who have been smokers most often develop this disease. The cause of AAA is unknown, but researchers believe that an inflammation in the aorta may weaken the aortic wall. This damage can be caused by smoking, high blood pressure and atherosclerosis, commonly known as hardening of the arteries. Atherosclerosis is caused by a buildup of cholesterol and other fatty deposits in the arteries. In atherosclerosis, fatty deposits called plaque build up in an artery. This buildup causes the artery to narrow, stiffen and possibly weaken. Besides atherosclerosis, other factors that can increase your risk of AAA include:
  • Having an immediate relative, such as a mother or brother, who has AAA
  • Having high blood pressure
  • Smoking

Abdominal aortic aneurysm tests

Abdominal aortic aneurysms are often detected through an imaging test, such as an X-ray or ultrasound, for another condition. During the examination, your physician will examine your abdomen and concentrate on any pulses or sensations in your legs. If AAA is suspected, you may have one of the following tests:
  • Abdominal ultrasound
  • CT scan of abdomen
  • MRI

Abdominal aortic aneurysm treatments

Depending on the size of the aneurysm and the symptoms you are experiencing, the prescribed treatment could be one of the following:
  • Endovascular stent graft repair
  • Open surgical aneurysm repair

Endovascular stent graft

Instead of open aneurysm repair, an endovascular stent graft may be an option. With this procedure, incisions are made in the groin and long, thin tubes called catheters are guided to the aneurysm using live X-ray pictures on a video screen. The stent graft is deployed within the aorta. Like the graft in an open surgery, the endovascular stent graft also removes the risk of rupture of the aorta. The procedure often has a short recovery, allowing a quick return to normal activities. Your hospital stay may be reduced to 1-2 days. However, an endovascular stent graft requires frequent imaging procedures after placement to check that the graft is operating correctly, and remains in the desired position within the aorta. A CT scan or abdominal ultrasound is usually performed 30 days, 6 months and 12 months post-surgery, and yearly thereafter, barring any problems.

In some cases the size and shape of a person’s blood vessels rule out endovascular repair. Some of the risks from this procedure include:
  • Injuries to the blood vessels or nearby organs
  • A leak around or behind an endovascular graft
  • Back pain
  • Fever
  • Blood clots in or around the graft or in the legs
  • Kidney failure
  • Infection
  • Heart attack, stroke or death

Open aneurysm surgical repair

With this method, a single large incision is made in the abdomen. The graft is then sewn into the artery above and below the aneurysm. Open surgery involves a longer recovery than an endovascular repair. But for some people, open surgery may be the only way to repair the aorta. Open surgery has been used for many years, and it has a good long-term track record. It may be recommended for younger people, to ensure that the graft lasts over time. Learn what to expect with aortic surgery.

Risks and complications include:
  • Heart attack or other heart problems
  • Pneumonia or other respiratory problems
  • Kidney failure
  • Blood clots in the legs
  • Bleeding
  • Infection at the incision site
  • Injury to the blood supply of the colon or spinal cord
  • Impaired sexual function (in men)
  • Infection or blood clot at the graft
  • Injury to the ureters
  • Stroke
  • Death
Learn more about endovascular aneurysm repair:
Medtronic Endovascular
Gore Medical