Abdominal Aortic Aneurysm (AAA)

An aneurysm is a swelling or enlargement of a blood vessel. An abdominal aortic aneurysm (AAA) is an aneurysm affecting your aorta, the largest artery in your body. The aorta originates from the heart and travels down your body, just in front of your spine. As it travels down your body it gives off branches, or arteries, that supply blood to all your organs, including your stomach, intestines, liver and kidneys. It finally splits into the iliac arteries at about the level of the belly button and supplies blood to the legs. Over 90% of aneurysms in the aorta occur in the section of the aorta in your abdomen just below arteries to the kidneys.

Over 80% of aneurysms occur in males and take years to form. There are no symptoms associated with the development of an aneurysm, and therefore, patients may not be aware they have an aneurysm until it ruptures. When an aneurysm ruptures, it causes intense back or abdominal pain and can cause loss of consciousness. Seventy to ninety percent of patients with a ruptured aneurysm will not survive. Doctors may detect an aneurysm prior to rupture by physical examination or by ultrasound, X-ray, CT or MRI. The risk of rupture of an aneurysm is related to the size of the aneurysm—the larger the aneurysm, the greater the risk. When the risk of rupture exceeds the risk of repair, your physician will recommend surgery.

SIGNS AND SYMPTOMS

  1. Most people do NOT have any symptoms.
  2. A mass may be felt in the abdomen, or a pulsation may be seen when the person is laying down.
  3. Pain may occur if the aneurysm presses on nerves or nearby organs.
  4. Small blood clots, called emboli, may shower from the aneurysm, moving into the feet, causing the toes to turn blue and painful.
  5. When an aneurysm bursts, there is sudden, severe pain that is felt in the abdomen or back. The person feels faint from low blood pressure and then rapidly goes into shock. Death will occur unless the blood pressure is maintained and the person receives surgical repair immediately.
  6. Most aortic aneurysms are found during examinations or tests performed for other reasons.

TREATMENT

The decision to treat a patient with an aortic aneurysm is based on the risk of the operation versus the risk of the aneurysm rupturing. Typically, surgery is recommended when the aneurysm reaches 4-5 cm in diameter. Some aneurysms are not treated until they are much larger if the patient is older or has other medical conditions that significantly increase the risk of surgery. Your surgeon will discuss this with you prior to repair.

The treatment of an abdominal aortic aneurysm is the replacement of the section of the aorta that is weak and dilated. This can be done with either conventional open surgery, endovascular surgery (minimally invasive techniques) or both.