Abdominal Aortic Aneurysm

An aneurysm occurs when a weakened part of a blood vessel expands like a balloon. An aneurysm in the main blood vessel  in your stomach area is called an abdominal aortic aneurysm (AAA).

Blood vessels that deliver oxygen-rich blood to the body are called arteries.  The aorta is the largest artery in the body.  An abdominal aortic aneurysm (AAA) is a weakening in the wall of the aorta in your abdomen.  The weakened wall stretches outward, expanding like a balloon.  As it expands the wall becomes thinner and thinner until, like a balloon, it can burst or rupture.  The rupture of an AAA can be a life-threatening event.  Aneurysm rupture affects about 15,000 people per year making it the 13^th leading cause of death in the United States.  Early detection and repair of AAA can prevent rupture.

Certain things increase your risk of having AAA.  There are many things known to contribute to the weakening of the aortic wall.

• Tendency to run in families
• More likely to develop as your get older
• Male gender
• Elevated cholesterol which can form deposits in the wall of the aorta
• Cigarette smoking, or history of smoking
• High blood pressure
• Inflammation or infection of the wall of the aorta (the causes of this are not known)

An aneurysm may be first noticed during a routine physical examination or test for another problem.  A complete examination and some tests are done to confirm AAA.

• History and physical examination.  Your physician may ask you if any of your relatives have had this problem since AAA can run in families.  AAA may be felt as a pulsating mass at about the level of the belly button.
• Ultrasound.  An ultrasound test uses sound waves to make images of your aorta and nearby blood vessels.
• CT Scan (computerized tomography).  CT scan uses special x-ray and contrast dye to form pictures of your aorta and blood vessels.
• MRI (magnetic resonance imaging or MRA (magnetic resonance angiogram)).   MRI uses radio waves and a strong magnet to show the blood vessels.

The risk of rupture of a small aneurysm is low.  The aneurysm might  not increase in size or it may increase in size slowly.  Your physician can monitor a small aneurysm on a regular basis with regular testing.  During that time, you will want to make changes to improve your health.

• Regular office visits.  Your physician may want to evaluate your aneurysm every 6 to 12 months with follow-up testing.  If you ever feel intense pain in your back or abdominal area, call you physician promptly.
• Make healthy lifestyle changes.  Changes that improve your health include stopping smoking, controlling your blood pressure and eating a healthy low fat, low cholesterol diet that is lower in sodium.

AAA can be surgically treated with either traditional open surgery or with a minimally invasive repair known as an endovascular procedure, meaning “within the blood vessels”.

• Open surgery.  This requires an incision in the abdominal wall.  The aorta is cut open and an aortic graft is sewn to the healthy aortic tissue above and below the weakened area.  The open surgery method is performed by a cardiovascular surgeon.
• Endovascular procedure.  This procedure requires two small incisions in the groin.  Using a x-ray imaging device, a catheter is guided up through the blood vessel in your groin into your aorta.  A graft is placed inside your aneurysm.  The graft contains metal hooks at either end that secure it inside your aorta.  The endovascular procedure is performed by an interventional radiologist or cardiologist often with the help of a surgeon.

Some people are more likely to get AAA than others.  Healthy changes in your life can reduce your risk for AAA in the future.

• Stop smoking
• Control your blood pressure
• Eat right
• Exercise regularly
• Lose weight
• Lower your cholesterol