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Abdominal Aortic Aneurysm

An aortic aneurysm is a weak spot in the wall of the aorta, the primary artery that carries blood from the heart to the head and extremities. There are three common types of aortic aneurysms: saccular, fusiform and dissecting.

Aortic aneurysms can occur in the following three locations:

  • Abdominal aortic aneurysms
  • Thoracic aneurysms
  • Thoracic abdominal aneurysms

Aneurysms are balloon-like swellings of the arterial wall that can occur in the portion of the aorta within the chest or just below the kidney in the abdomen. The risk is that an aneurysm will eventually rupture, causing extensive internal bleeding and a complete collapse of circulation. Sudden severe pain, shock and loss of consciousness usually occur within seconds, and death is imminent in more than 50 percent of cases, even with emergency surgery. Thus, the goal is to detect and treat an aortic aneurysm before it ruptures. Aortic aneurysms generally affect people over 60 and are more common among men.

When to Call Your Doctor

See your doctor regularly if you suffer from high blood pressure or high cholesterol, each a major risk factor for the different types of aneurysms.

Symptoms

In the majority of aneurysm cases, there are no warning symptoms. More likely, an aortic aneurysm is detected with an x-ray or during a routine physical examination.  Some additional symptoms include:

  • A throbbing lump in the abdominal area
  • Severe backache
  • Leg pain
  • A feeling of coldness in the leg
  • Severe abdominal pain


Causes

Though an exact cause of aneurysms cannot be named, there are several conditions and lifestyle factors that have been associated with their development. It is clear that a family history of aortic aneurysms substantially increases risk.

  • Approximately 95 percent of aortic aneurysms are associated with atherosclerosis, the narrowing of an artery due to the buildup of fatty plaque.
  • The muscular middle layer of the artery may be congenitally weak and thus prone to an aneurysm.
  • High blood pressure (hypertension) intensifies the force of blood on the walls of the arteries and contributes to the development of aneurysms.
  • The arterial wall may be weakened as a result of trauma or complication of other diseases, possibly leading to aneurysms.


Prevention

Prevention measures include a diet low in cholesterol and saturated fats to reduce the risk of atherosclerosis. It is also important to take steps to prevent, detect and treat high blood pressure.

If you have a family history of aortic aneurysms, you are at an increased risk and should be aware of the symptoms, as they are more likely to develop at a young age. (They are also more likely to rupture, so early treatment is essential.)

If you are determined to be at high risk, you may want to consider periodic ultrasound screenings with your physician.


Diagnosis

During your evaluation for aortic aneurysm, a physician will examine you. If necessary, you may be asked to undergo Ultrasounds and X-rays. Some tests may be conducted in the Vascular Laboratory, in the hospital, or your doctor's office.

  • Regular physical exams: It is important that you have regular physical exams to detect an aortic aneurysm before it has a chance to rupture.
  • Chest X-rays, computed tomography (CT) scans or ultrasound imaging are used to confirm the presence of an aneurysm. During a CT scan, you will lie on a table while an X-ray tube revolves around your body to direct X-rays through your chest at different angles and give the doctor a better picture of your blood vessels. Ultrasound uses high-frequency sound waves to examine your organs. 
  • Angiography is an X-ray of the inside of the arteries.
  • Ultrasound examinations are performed periodically to follow the expansion of an aneurysm over time.

Your physician may ask you to return for regular physical exams to track an aortic aneurysm and ensure that it doesn’t rupture.


Treatment

Treatment options for aortic aneurysms can include the following:

  • Endografting: This technique is minimally invasive.  The surgeon makes a small nick in the groin and inserts a catheter into a blood vessel that leads to the aorta. An endograft, is inserted through the catheter and moved to the site of the aneurysm. 
  • Certain aneurysms may require surgical removal of the affected portion of the artery. 
  • Treatment of an unruptured aneurysm has a 90 to 95 percent success rate.
 

                   

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