Abdominal Aortic Aneurysm (AAA)
What is it?
An aneurysm is a bulge in the wall of an artery,
usually the aorta. The aorta is the largest blood vessel
in the body. It receives all the blood from the left
ventricle of the heart, and continues from the heart,
through the chest, and on to the abdomen. It supplies
blood to every organ in the body, except the lungs. An
abdominal aortic aneurysm (AAA) affects the segment of the
aorta that runs through the abdomen.
Who gets it?
Abdominal aortic aneurysm is common in older adults.
There appears to be a genetic link because this type of
aneurysm tends to run in families. People who smoke
cigarettes are more likely to die from a ruptured
abdominal aortic aneurysm than nonsmokers.
What causes it?
Abdominal aortic aneurysm usually occurs in people with
atherosclerosis, also known as hardening of the arteries.
As the arteries harden, the wall of the aorta is damaged
and weakened. The pressure of the blood flow inside the
aorta causes the weakened wall to bulge outward. High
blood pressure also contributes to weakened aortic walls.
What are the symptoms?
Abdominal aortic aneurysm may not cause any symptoms at
first. When symptoms do occur, they include a pulsing
sensation in the abdomen, and pain ranging from mild to
severe. Pain may be located in the abdominal, back, or
groin area. Sudden, excruciating pain in the lower abdomen
and back pain usually indicates a ruptured aorta, which
needs to be treated immediately.
How is it diagnosed?
Because abdominal aortic aneurysms may not cause any
symptoms until the condition has progressed, they are
usually diagnosed by chance during a routine physical
examination. The doctor may feel a pulsing, tumor-like
mass in the middle of the abdomen. If the aneurysm is
about to rupture, it may hurt or feel tender when pressed.
It is important to determine its size because the larger
the aneurysm, the greater the risk of rupture. The most
commonly used test is an abdominal ultrasound, a painless
procedure in which a small scanning device is pressed
against the abdomen. Sound waves bounce off the internal
organs and produce a picture on a video screen. The
picture shows the size and length of the aneurysm.
What is the treatment?
Treatment depends upon the size of the aneurysm. If the
aneurysm is less than 4 cm (1.5 in) wide, surgery is not
necessary, but your doctor will monitor it carefully for
an increase in size. Aneurysms between 4 and 5 cm (1.5 - 2
in) wide may be treated with surgery if you and your
doctor determine that is the best course of treatment.
Aneurysms that are larger than 5 cm (2 in) or are causing
symptoms are always treated with surgery, unless it is
considered risky because of other health problems. The
surgeon makes an incision in the abdomen, removes the
aneurysm, and repairs it with a synthetic patch, called a
graft. This type of surgery has a very high success rate.
There is also another type of surgery called endovascular
grafting, which involves inserting a thin tube called a
catheter through a groin artery into the abdominal aorta.
The catheter's tip holds a deflated balloon that is
covered by a tightly folded graft. When the catheter is in
position, the balloon is inflated, which causes the graft
to open to span the length and width of the aneurysm.
Devices at each end of the graft secure it to the inner
wall of the aorta to strengthen the wall and prevent it
from rupturing. This surgical method may not be available
at all hospitals at this time and is only used for
non-emergency repairs. Emergency surgery is performed when
the abdominal aortic aneurysm has ruptured or is about to
rupture. Because a ruptured aneurysm causes internal
bleeding, there is a risk of damage to internal organs,
such as the kidneys, because their blood supply is
interrupted. If a ruptured abdominal aortic aneurysm is
not treated, it always results in death.
Self-care tips
You can reduce your risk of abdominal aortic aneurysm
by not smoking and keeping your blood pressure under
control. If you have an abdominal aortic aneurysm that
does not need to be treated by surgery at this time, keep
regular appointments for ultrasound scans of the aneurysm
to monitor it for changes in size. Some aneurysms can grow
larger in a matter of months. If you have had surgery to
repair an abdominal aortic aneurysm, it is good to know
that they usually do not occur again, and that you are not
at any greater risk for developing aneurysms in other
areas of the body.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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