What is an Abdominal Aortic Aneurysm? - Peripheral Vascular Associates
What is an Abdominal Aortic Aneurysm? - Peripheral Vascular Associates

What is an Abdominal Aortic Aneurysm?

NEWS

An aneurysm is a dilation or swelling of a major artery of the body. When it swells, it loses strength and integrity, and it could rupture or break. When an aneurysm occurs in the aorta between the diaphragm and the pelvis, it’s called an Abdominal Aortic Aneurysm. 

Most abdominal aneurysms are found when medical professionals are looking for something else. You might get an ultrasound to look at your gallbladder, for example, or a CAT scan, and the aneurysm will be found incidentally. 

As the vessels are deep inside the chest or abdomen, many patients often don’t experience symptoms or even know that anything is wrong. Other patients, however, may experience discomfort in their abdomen or back, or other signs like discolored toes or difficulty walking, which can be signs that a clot has broken loose and is disrupting other vessels in the body. When an aneurysm ruptures, symptoms can develop rapidly. 

Symptoms of a Ruptured Aneurysm

  • Severe, sudden, or constant back or abdominal pain, which may also be felt in the groin, buttocks or legs
  • Nausea and vomiting
  • Rapid heartbeat
  • Skin that feels cool and moist
  • Shock

Unfortunately, by the time patients begin to experience more noticeable symptoms, the window for the safest and least invasive treatments may have already closed. 

That’s why it’s so important for people who are at risk to undergo regular screenings and enable early diagnosis and treatment. Smoking is a particular risk factor for AAA – in fact, a history of smoking accounts for about 75% of all abdominal aortic aneurysms(1). Men are also at higher risk, with 58% of 2018 deaths due to aortic aneurysm or aortic dissection happening among men(2). The U.S. Preventive Services Task Force recommends that men between the ages of 65 and 75 with a history of smoking should get an ultrasound screening for AAA, even if they show no symptoms. 

Risk factors for AAA: 

  • A history of smoking
  • High blood pressure
  • High cholesterol
  • Emphysema
  • Genetic factors

Not every aneurysm needs to be treated – some just need to be monitored through observation and imagining. But in cases where intervention is warranted, there are two primary options to treat it: open surgery or a more minimally invasive endovascular surgery. 

Open Aneurysm Repair

In open surgery, a patient undergoes an abdominal procedure in which doctors cut out an aneurysm in its entirety, replacing the affected section of the artery or aorta with a graft. After open surgery, patients typically spend about a week in the hospital and then another four to five weeks recovering before they can return to normal activity. 

Endovascular Surgery

The endovascular surgery approach is less invasive, utilizing a covered stent shrunken inside a catheter which, when inserted, excludes the aneurysm from circulation, shrinking it and depressurizing it. Although the aneurysm is still present, the risk of it rupturing is drastically reduced. 

The recovery from the endovascular option, meanwhile, is much shorter. Patients go home the next day and spend about a week recovering. Since there is no large incision, patients are typically able to resume normal activities after two to three weeks. 

Outcomes for both courses of treatment are often excellent, with very low rates of recurrence or other problems. Both treatment options do require continued monitoring both to ensure there is no recurrence of the aneurysm, or in the case of the endovascular approach, that the graft hasn’t migrated. Visit our Conditions page to learn more about Abdominal Aortic Aneurysms or our Treatments page for information about open Abdominal Aortic Aneurysm repair.

 

1 Norman PE, Curci JA. Understanding the effects of tobacco smoke on the pathogenesis of aortic aneurysm. Arterioscler Thromb Vasc Biol. 2013;33(7):1473–7.
2 Centers for Disease Control and Prevention, National Center for Health Statistics. Underlying Cause of Death 1999–2018 on CDC WONDER Online Database website. http://wonder.cdc.gov/ucd-icd10.html.

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