Aortic Abdominal Aneurysm: Detection, Therapy, and Warning Signs
An abdominal aortic aneurysm (AAA) is a bulge in the aorta, the main artery that carries blood away from the heart to the rest of the body, located in the abdomen. If left untreated, an AAA can lead to serious complications, including rupture, which can cause life-threatening internal bleeding.
AAAs can develop due to a buildup of pressure in the artery and a weakening of the artery wall, often caused by plaque, a fatty substance in the blood. Doctors might class an AAA as small, medium, or large to guide treatment.
Small AAAs, measuring 3-4.4 cm in diameter, may not require treatment. However, larger AAAs, greater than 5.5 cm in diameter, usually require surgery to prevent rupture, which becomes increasingly likely as the aneurysm grows beyond this size. Medium AAAs, measuring 4.5-5.4 cm in diameter, may require regular monitoring.
Common treatment options for larger AAAs primarily involve surgical intervention. The two main surgical approaches are open surgical repair and endovascular aneurysm repair (EVAR).
Open surgical repair involves a large abdominal incision to expose the aorta and replace the weakened aneurysm segment with a synthetic graft. This is a traditional method that is effective but requires a longer recovery time.
EVAR, on the other hand, is a less invasive technique that uses catheters to place a stent graft inside the aneurysm via small incisions in the groin, reinforcing the weakened artery from within. EVAR generally has a quicker recovery and shorter hospital stay compared to open repair.
Elective repair is generally recommended for asymptomatic AAAs measuring ≥ 5.5 cm in diameter in men (≥ 5.0 cm in women), assuming the patient has acceptable surgical risk. Surgery is usually advised urgently within weeks for large AAAs due to the high risk of rupture without intervention.
For patients unfit for surgery or those with smaller aneurysms, active surveillance with regular imaging and medical management—such as blood pressure control and smoking cessation—may be pursued. However, this carries ongoing rupture risk.
It is essential to seek immediate medical attention if an AAA causes any symptoms, including persistent and severe back or stomach pain, dizziness and confusion, nausea and vomiting, shortness of breath, low blood pressure, and a rapid heart rate. Males who are 65 years of age or older and have ever smoked should get an ultrasound screening for AAA.
Other complications of an AAA may include infections, fistulas, pseudoaneurysms, and blood clots. The outlook for a person with an AAA will depend on its severity, and people with a known AAA may need to see a doctor for checkups every 6-12 months.
In summary, prompt diagnosis and appropriate treatment are crucial in managing AAAs. Open repair and EVAR significantly reduce rupture risk once the AAA exceeds 5.5 cm in diameter and are considered standard care for these patients. Regular check-ups and lifestyle changes, such as quitting smoking, can help prevent the development and progression of AAAs.
- Aortic aneurysms, such as abdominal aortic aneurysms (AAAs), are medical-conditions that affect vascular health and can lead to serious complications like internal bleeding if left untreated.
- Larger AAAs, greater than 5.5 cm in diameter, often require medical intervention, with surgical approaches like open repair or endovascular aneurysm repair (EVAR) available as treatment options.
- Surgical repair of larger AAAs, whether through open repair or EVAR, can help prevent rupture and improve cardiovascular health, particularly in patients with acceptable surgical risk.
- Maintaining a healthy lifestyle, such as quitting smoking and controlling blood pressure, can help prevent the development and progression of AAAs and improve overall health-and-wellness.
