Abdominal aortic aneurysm (AAA)
What is an abdominal aortic aneurysm (AAA)?
The aorta, the largest artery in our body, starts at the heart, goes 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 AAA each year, and about 15,000 die each year from a ruptured 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 cut off blood flow, causing severe pain or even loss of limbs if circulation is stopped for a long time.
Symptoms
Most people have no symptoms, and an AAA 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
Most aortic aneurysms are caused by the breakdown of proteins that provide structural support to the wall of the aorta.
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 AAA
- Smoking
- High blood pressure
- Chronic lung disease
Diagnosis
If we suspect an AAA, we do an abdominal aortic aneurysm triplex, which is a painless, safe test that can visualize and measure the size of the AAA. With computed tomography angiography (CTA), we can see the size of the aneurysm, its location, and its risk.
Treatment
Vascular surgeons decide the best procedure for the patient, based on the size of the aneurysm and other factors.
For smaller AAAs, lifestyle changes are needed, such as quitting smoking and controlling blood pressure. Medication may also be given. The vascular surgeon recommends regular check-ups to see if the AAA has changed.
For larger AAAs, 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 is properly trained in both repair methods. The repair method is very important for long-term durability and prevention of rupture.
With the specialization and technological advancements available at the Athens Medical Center, even the most complex cases of aneurysms of the entire aorta are treated.
