Abdominal Aortic Aneurysm
What is Abdominal Aortic Aneurysm?
An Abdominal Aortic Aneurysm (AAA) is a swelling of the aorta, the main blood vessel that leads away from the heart. When the wall of a blood vessel weakens, a balloon-like swelling called an aneurysm can develop. The abdominal aorta is the largest blood vessel in the body, leading down through the abdomen to the rest of the body. AAAs can be very serious.
What causes Abdominal Aortic Aneurysm?
Aneurysms can develop anywhere along the aorta, but they are most common in the abdomen. The following factors are commonly found to contribute to an AAA:
Inflammation – any type of inflammation that causes the wall of the aortic artery to weaken.
Hardening of the arteries (Atherosclerosis) – when fat and other substances build up on the lining of a blood vessel.
Family history - aneurysms run in families. If a first-degree relative has had an AAA, you are 12 times more likely to develop an AAA.
Age and other risk factors – (50+ for men, 60+ for women) and a history of Atherosclerosis, high blood pressure, elevated cholesterol, smoking and heart or peripheral vascular disease.
Infection - a bacterial or fungal infection in the aorta.
Trauma – for example being in a car accident.
CTD - congenital connective tissue disorders.
What are the symptoms of Abdominal Aortic Aneurysm?
Often AAAs cause no symptoms at all and are found when you’re being evaluated for another medical condition. Some aneurysms never rupture. Some grow slowly and stay quite small. Others produce the following symptoms as they get bigger:
Sudden, severe abdominal or back pain - If you have a family history of AAA and feel sudden, severe abdominal or back pain, seek immediate medical care. These symptoms may signal that you have an AAA, possibly in process of rupturing.
Deep, constant abdominal pain - If you have an enlarging AAA, you might notice a deep, constant pain in your abdomen or on the side of your abdomen. You might also feel a pulse near your belly button.
Problems with your feet and toes - In rare cases, people with an AAA may have pain, sores or discoloured skin on their feet and toes as a result of plaque or blood clots from elsewhere in the body collect in the feet and toes.
How is Abdominal Aortic Aneurysm diagnosed?
Usually AAAs cause no symptoms and are found when you’re being treated or evaluated for another medical condition. If found, a vascular surgeon can help work out the best course of action. It’s important to understand that if a large aneurysm bursts, it causes huge internal bleeding and is usually fatal. Careful monitoring is required if you have family history or have been previously diagnosed with an AAA.
An abdominal ultrasound may be used to screen and measure the size of an AAA and further diagnostic tests may be needed such as a computed tomographic angiography or CTA where an intravenous dye is used to work out the valuable information about the AAA.
How is Abdominal Aortic Aneurysm treated?
Treatment depends on the size of the aneurysm.
Small AAA (less than 5 cm in diameter)
Very low risk of rupture.
Ultrasound every 6–12 months to monitor growth and risk of rupture.
Control blood pressure through lifestyle changes (eg daily exercise, stopping smoking) and medication.
Large AAA (more than 5.0-5.5 cm in diameter)
Rapidly enlarging, causing symptoms.
A vascular surgeon may repair the AAA using a prosthetic graft through an incision in your abdomen (open surgery).
Most patients stay in the hospital 4–10 days. Recovery time may be up to 3 months.
Endovascular aneurysm repair (EVAR) is a less invasive treatment that uses two small incisions in the groin (keyhole surgery).
A tiny device is placed into the artery to reinforce the artery wall and exclude the aneurysm.
Most patients stay in the hospital 1–3 days. Recovery time is shorter than with open surgery.
How do I prevent Abdominal Aortic Aneurysm?
From healthy lifestyle choices to knowing your family history – there are many ways you can help prevent an AAA:
Know your risk – Does AAA run in your family? Share your history and help educate other first-generation relatives of their increased risk.
Look after your health – Follow a healthy, low-salt diet and stay active with regular exercise.
Quit smoking – Ask your vascular surgeon for help to quit smoking for good.
Get checked – Have your blood pressure and cholesterol checked regularly and speak to your doctor about whether control medications may help.
Talk to your doctor
If you have any concerns about Abdominal Aortic Aneurysm, speak to the team at Vascular Associates.