Abdominal Aortic Aneurysm

Aorta is the main blood vessel of the body. When it's walls weakens it can become aneurysmic ballooning outward and becomes at risk for rupture,

Causes, incidence, and risk factors

The exact cause is unknown, but risk factors for developing an aortic aneurysm include:

Smoking
High blood pressure
High cholesterol
Male gender
Emphysema
Genetic factors
Obesity

An abdominal aortic aneurysm can develop in anyone, but is most often seen in males over 60 who have one or more risk factors. The larger the aneurysm, the more likely it is to rupture.

Symptoms

Aneurysms develop slowly over many years and often have no symptoms. If an aneurysm expands rapidly, tears open (ruptured aneurysm), or blood leaks along the wall of the vessel (aortic dissection), symptoms may develop suddenly. The symptoms of rupture include:

Pain in the abdomen or back -- severe, sudden, persistent, or constant. The pain may radiate to the groin, buttocks, or legs.
Clammy skin
Nausea and vomiting
Rapid heart rate
Shock

Signs and Tests

Your doctor will examine your abdomen. The exam also will include an evaluation of pulses and feeling in your legs. The doctor may find:

A lump (mass) in the abdomen
Pulsating sensation in the abdomen
Stiff or rigid abdomen

You may have an abdominal aortic aneurysm that is not causing any symptoms or problems. Your doctor may find this problem by doing the following tests:

CT scan of the abdomen
Ultrasound of the abdomen

Either of these tests may be done when you're having symptoms.

Treating an AAA

When an aneurysm is small, your doctor may recommend periodic checkups to monitor it. If an aneurysm is larger, or is rapidly growing, it has more risk of bursting. If your doctor thinks there is a risk the aneurysm may rupture, he or she may recommend treatment. There are two types of treatment for AAA:

Open Surgical Repair
Endovascular Repair

The goal of all AAA repair is to prevent the aorta from bursting.

Important Note: Not every patient is a candidate for endovascular repair. Open surgical repair and endovascular repair both have advantages and disadvantages based upon each patient’s condition and needs. Discuss the advantages and disadvantages with your doctor.

Endovascular Repair

Endovascular means “inside or within a blood vessel.” Instead of making a large incision in the abdomen, the doctor makes a small cut near each hip (near the crease between the abdomen and thigh) to get to the femoral arteries (blood vessels). Through these small cuts, a graft (fabric tube) is inserted into the arteries and positioned inside the aorta. The endovascular graft seals off the aneurysm. The graft makes a new path through which the blood flows. The graft remains inside the aorta permanently. Endovascular repair typically takes one to three hours to complete. Because there are smaller cuts than those in open surgical repair, endovascular repair may result in less discomfort, shorter hospital stay and faster recovery. Patients may have a hospital stay of only a few days. They can usually return to normal activity within four to six weeks after the procedure. As with any medical procedure, endovascular repair has a risk of complications. Endovascular repair also requires routine follow-up visits with your doctor. Tests are done to evaluate the procedure and monitor success of the treatment. There is also a possibility that additional treatment or surgery may be required after the initial endovascular repair.

Prevention

To reduce the risk of developing aneurysms:

Stop Smoking

People over age 65 who have smoked at any time in their life should have a screening ultrasound performed once.

Please call with any questions:

Daniel J. McGraw, MD
705 Garfield Avenue, Suite 460
Parkersburg, WV 26101

304-424-2093 866-853-2093