When the wall of a blood vessel weakens, a dilation called an aneurysm can develop. This happens most often in the abdominal portion of the aorta. The aorta is the main artery that comes directly off your heart and runs through the chest and abdomen supplying blood to the rest of the body. If you have an aortic aneurysm then our goal is to prevent rupture and possible subsequent death.
What puts you at risk for AAA
Smoking, increasing age, and male gender are primary risk factors for developing aortic aneurysms. Also, a family history of aortic aneurysms can put you at higher risk as well.
Symptoms of AAA
- There are usually no symptoms with the presence of aortic aneurysms. Most AAA's are found when patients are undergoing imaging test (CT SCAN, MRI, or ultrasound) of the abdomen for other problems.
- If you have a known AAA and you feel sudden, severe pain in your abdomen or back, seek immediate care in your nearest emergency room. These symptoms may mean that you have a ruptured AAA.
Diagnosis of AAA
As mentioned above most AAA’s are incidentally found on other imaging test of the abdomen being performed for other reasons. Ultrasound is the most common test used to screen for, measure the size of, and follow up on AAA’s. measure the size of an AAA. CT scans are used to measure specific aspects of aortic aneurysms to decide whether surgery is needed, and how best to fix the aneurysm.
When to repair AAA
Treatment depends on the size of the aneurysm. The larger the aneurysm the higher the risk of rupture.
- Small aneurysms than or less than 5 cm in size have a very low risk of rupturing, but should be monitored with ultrasound every 6-12 months.
- Aneurysms that are greater than 5 cm in size, increasing in size or causing symptoms should be repaired.
Treatment of AAA
There are two ways to treat AAA. A minimally invasive technique called endovascular aneurysm repair (EVAR) and traditional open AAA repair.
- Open surgery requires an incision on the abdomen, and placement of a man made graft to replace the aneurysm. Most patients stay in the hospital 5-7 days, and full recovery time may be up to 3 months.
- Endovascular aneurysm repair (EVAR) is a less invasive treatment, only requiring small groin incisions or sometimes only a needle-stick. Using x-ray imaging, a special stent can be placed inside the aneurysm to repair it. Most patients stay in the hospital 1–3 days. Recovery time is shorter than with open surgery. Most aneurysms (about 75%) of aneurysm patients can be treated by EVAR.