Abdominal Aortic Aneurysm
Abdominal Aortic Aneurysm
What It Is
Abdominal Aortic Aneurism, or AAA, is a weakening, or bulge, in the wall of your aorta – the large artery in the middle of your body that descends through the abdomen and spits into the arteries that supply blood to your legs & lower extremities. If the aneurysm, which is rather like a balloon, sustains enough pressure, it can rupture and cause internal bleeding, shock, or even death.
Early diagnosis is a key element in successful treatment, because a ruptured AAA is fatal 95% of the time, while an electively repaired AAA has a survival rate of 95%.
AAAs are usually discovered during an examination for another complaint, or in an x-ray or scan ordered for an unrelated issue. So, most diagnoses occur before the onset of symptoms. A ruptured aneurysm is a life-threatening emergency that requires immediate medical attention, though, so you should be aware of symptoms, which may include the following:
• A “pulsing” sensation in your abdomen, sort of like a heartbeat between your ribs and navel
• Sharp, sudden pain in your abdomen or lower back, sweating and general weakness
• Pain or discoloration in the feet is a less common symptom, but may indicate embolisms
The specific causes of AAA are unclear, but there are several known predictors:
• Atherosclerosis, also called “hardening of the arteries”
• High blood pressure
• More common in men than women
• More common in men over 60
• More common among those whose close relatives have had AAA
• History of other aneurysms
If your physician suspects an AAA, an imaging test will probably be ordered – an abdominal ultrasound, CT scan, or MRI.
Non-operative treatment may be indicated if your AAA is small. Your physician monitors the aneurysm for changes in size with regular scans. In the meantime, you may be prescribed medication to regulate your blood pressure, and if you smoke, you must stop. Coughing related to heavy smoking or COPD can cause an aneurysm to rupture. An aneurysm does not go away or heal itself, but it may remain small enough to present no health problems.
If the aneurysm grows beyond a certain size, surgery may be necessary. To surgically repair an aneurysm, your surgeon makes an incision in your abdomen and replaces the weakened part of your aorta with a graft. This graft is made of plastic material, and functions just like a healthy aorta. You may remain hospitalized four days to a week post-op, and complete recovery may take weeks or even months. Again, long-range success rates for aneurysm repairs exceed 90%.
On option to abdominal surgery is an endovascular stent graft. Endovascular means accessing the aorta through blood vessels; a stent is an artificial sleeve placed inside the site of the aneurysm to strengthen your aorta. This procedure is less invasive, requiring small incisions in your groin, and your hospital stay is much shorter – usually two or three days. This procedure does require regular follow-up scans, and not all patients are good candidates.