Abdominal aortic aneurysm (AAA): Prevention & treatment
What is an abdominal aortic aneurysm (AAA)?
The aorta, the largest artery in our body, starts at the heart, runs through the chest, and ends at the abdomen.
An abdominal aortic aneurysm occurs when the wall of the aorta progressively thins and begins to bulge. It can continue to grow and suddenly rupture if left untreated, causing serious internal bleeding and possible death. Nearly 200,000 people in the United States develop a new AAA each year, and about 15,000 die each year from a recurrent AAA.
In addition to rupture, blood clots or atheroma can also form within an AAA. These can travel to other areas of the body and block blood flow, causing severe pain or even loss of a limb if the flow is stopped for a long time.
Symptoms
Most people have no symptoms, and an ACA is often found during tests for other reasons. Those who do have symptoms usually report back pain, abdominal palpitations, severe pain, and leg ulcers.
Causes and risk factors
Aortic aneurysms are caused by the destruction of proteins that provide structural support to the aortic wall, and their development is multifactorial, with genes (about 130) playing an important role. Some risk factors that can contribute to this are:
- Age (especially people over 60 years old)
- Gender (men are more susceptible)
- History of atherosclerosis
- Family history of CAD
- Smoking
- High blood pressure
- Chronic lung disease
Diagnosis
As part of preventive screening, imaging of the abdominal aorta is necessary, especially in men over 65, in hypertensive patients with peripheral arterial disease and especially with a family history of aneurysm, regardless of gender. If we suspect an ACA, we perform an abdominal aortic aneurysm scan, which is a painless, safe test that can visualize and measure the size of the ACA. With computed tomography angiography (CTA), we can see the size of the aneurysm, its location, and its risk, and plan the appropriate intervention.
Treatment
Vascular surgeons decide the best surgery for the patient, based on the size of the aneurysm and other factors.
For smaller ACAs, lifestyle changes are needed, such as quitting smoking and controlling blood pressure. Medication may also be administered. The vascular surgeon recommends regular check-ups to monitor whether the aneurysm changes.
For large aneurysms, or those that grow over time, repair can be done with endovascular graft placement or open surgical repair.
The patient should be sure to see an experienced surgeon who has been properly trained in both repair methods. The choice of the type of repair is very important for long-term durability and the avoidance of rupture.
With the specialization of the staff and the advancement of technology available at the Athens Medical Center (Hybrid Surgery), even the most complex cases of aneurysms of the entire aorta are treated.
