Understanding Abdominal Aortic Aneurysm

Abdominal Aortic Aneurysms

Arteries are muscular tubes that carry oxygen and nutrient rich blood away from the heart and toward the rest of the body. The largest artery in the body is located in the chest and carries blood directly from the heart. It is called the aorta. The part of the aorta that passed through abdomen in called the abdominal aorta. The abdominal aorta branches into two smaller arteries called the lilac arteries which supply blood to the organs in the abdomen, including the kidneys and legs.

When the abdominal aorta weakens and expands, it becomes an abdominal aortic aneurysm (AAA). The pressure from blood flow can cause a weakened area of the abdominal aorta to expand and form a balloon-like bulge. An AAA poses a health risk because it can burst or rupture. This is can cause severe internal bleeding, which can be fatal.

Luckily, AAA can be treated and even cured, especially when diagnosed early.

An AAA is often causes no symptoms. It is usually found during a routine exam or if tests are done to an unrelated problem. If you do experience symptoms, these may include:

  • Pulsing feeling in the abdomen (similar to a heartbeat)
  • Severe, sudden pain in your abdomen or lower back. If you experience this, contact your doctor right away. It may be a sign your aneurysm is about to rupture.
  • You may experience pain, discoloration, or sores on the toes or feet due to material shed from the aneurysm

How does an AAA develop?

An AAA usually begins to form when the lining of the aorta is damaged, or the aorta may become weakened due to hereditary risk factors. A weakened artery will expand like balloon, creating a bulge called an aneurysm. This causes the expanded walls to become thinner and weaker, such that it is susceptible to rupture (leaks, bursts, or tear open). Plaque, a substance composed of cholesterol, may accumulate along the weakened artery wall. Blood may also thicken forming clots inside the artery. This may not cause symptoms because blood can still flow through the clot. High blood pressure may also further strain the artery walls.

An AAA can be fatal if not treated quickly.

Risk factors
Although anyone can have AAA, certain factors increase the risk of an AAA forming or rupturing. These risk factors include smoking, having a close family member with an AAA, blood vessel disease in another part of body, high blood pressure, and being over 55 years old if you are a man, or being over 65 years old if you are a woman.

What tests will I have?

In order to determine the size of your aneurysm, your doctor will perform an evaluation. Your evaluation will include a patient history and exam. Your doctor will ask questions about your health history and your family medical history. During your physical exam, your doctor will examine your abdomen.

In addition, you may have imaging tests done to create pictures of the arteries and help determine the size and shape of the aneurysm. They include:

  • Ultrasound: This test uses sound waves to create an image of the arteries and veins. During the test, your healthcare provider will move a sensor across your abdomen.
  • CT (computed tomography): A series of x-rays are taken using a special x-ray machine. These x-rays are used by a computer to create an accurate 3D image of the aneurysm. You may be injected with contrast fluids via an IV line which will help show the arteries clearly.
  • MRI (magnetic resonance imaging): This test uses a strong magnet to create images that analyze energy released by tissues in the body.

 These tests may be performed before the artery repair:

  • Arterial Doppler study: This test measures blood flow in the leg by using a special probe and blood pressure cuff placed on the leg.
  • Arteriography: This test makes an x-ray image by showing the blood flow through the aorta and other arteries and to prepare for future surgery.

Treatments for Abdominal Aortic Aneurysm

Endovascular Repair

During this procedure, your surgeon places a graft composed of wire mesh and fabric inside the abdominal aorta thus taking pressure off the weak artery wall. During the procedure, two small incisions are made in the groin and a catheter is guided through an artery at the incision sites. One of the catheters carries the collapsed graft to the damaged artery. Your surgeon guides the graft toward the damaged area of aorta using x-rays. The catheters place the graft into position and then your surgeon expands the graft. Metal springs and hooks above and below the aneurysm keep the graft in place. Your surgeon will then remove the catheters. Because the surgery is minimally invasive, you can expect a short recovery and a quick return to your normal routine.

Open Surgery Repair

During this procedure, your surgeon replaces the weakened wall of the abdominal aorta with a graft composed to strong, flexible fabric. This allows blood to safely flow through your abdominal aorta and lower body. This repair uses a single large incision made in the abdomen or flank. Your surgeon will carefully move your organs aside in order to reach the aorta. The aorta is then clamped to prevent blood flow. The aneurysm is opened and cleared of blood clots. Your surgeon will sew the graft into the artery above and below the aneurysm. The aorta is then sewn together around the graft. In order to create a snug fit, some of the aorta wall may be removed. Your surgeon will then close the incision site.

If you have questions about AAA treatment, let us know. 
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