Abdominal Aortic Aneurysm
An aneurysm is a bulging or ballooning of a vessel wall. In the
case of an abdominal aortic aneurysm (abbreviated AAA and sometimes
referred to by healthcare professionals as “triple A”),
this is a bulging of the wall of the main vessel that delivers
oxygen-enriched blood from the heart to the entire body. This weakness
within the vessel wall can create a life-threatening danger because
of the possibility of its rupture.
Abdominal aortic aneurysm is the thirteenth leading cause of death
annually in the United States. The incidence of this condition
is four times higher for men than it is for women. There seems
to be a genetic link to its occurrence, and a family history of
AAA increases the risk for development.
Those with atherosclerosis (hardening of the arteries) are more
likely to develop AAA. The atherosclerotic build-up on the arterial
wall weakens and impairs the vessel that may result in the artery
bulging outward. In the presence of high blood pressure, the elevated
pressure further contributes to the occurrence.
Symptoms of Abdominal Aortic Aneurysm
The presence of this type of aneurysm may actually cause no symptoms
at all and remain a completely silent, undetected condition. This
makes it highly dangerous since its presence may be unknown until
the time it ruptures.
Symptoms, when demonstrated, may include mild to more severe discomfort
in the abdomen, back, or pelvic regions. A pulsing sensation may
also occur in the abdominal region. Symptoms of rupture may include
acute onset of unbearable pain in the back or abdominal area.
Diagnosis of Abdominal Aortic Aneurysm
An ultrasound study is the most common method of identifying the
presence of AAA.
CT (computerized tomography) scanning or MRI (magnetic resonance
imaging) may also reveal this condition. Because an abdominal aortic
aneurysm may exist without symptoms, its presence is often discovered
on imaging studies that are being conducted to
diagnose other conditions. It is also possible to discover AAA
through physical examination when the pulsation created by the
aneurysm is detected by your physician.
Treatment of Abdominal Aortic Aneurysm
Treatment recommendations will depend on the size or diameter
of the AAA. Your general physical health will also be a factor
in the specific method of treatment selected.
Abdominal aortic aneurysms that are 5 cm (about 2 inches) in diameter
are generally treated by surgical intervention. Those of smaller
diameters and present without
symptoms are watched for growth via imaging studies. If you have
high blood pressure, it will be important to maintain adequate
blood pressure control in the presence of an existing AAA. Your
medication regimen may require adjustment to ensure safe blood
pressure parameters.
Conventional surgical treatment for AAA involves a long abdominal
incision to access the aorta, accomplish removal of the aneurysm,
and place a graft at the resection site of the aneurysm. This is
a major procedure with the possibility of significant complications
involving the body’s major organ systems. Recovery times
from this surgery are generally six to eight weeks.
A recently developed nonsurgical intervention is also an option
for the treatment of an abdominal aortic aneurysm. This involves
placement of a stent graft at the site of the aneurysm to alleviate
the pressure of the blood flow against the arterial walls. The
procedure, known as endoluminal stent grafting, is accomplished
through access from major peripheral vessels using a special catheter
to place the graft at the aneurysm site.
This may be a safer option for AAA treatment in elderly patients
or in those where other health conditions make a traditional surgical
intervention a high-risk situation. Not all patients are candidates
for endoluminal stent grafting. Vessel size must be adequate to
allow for successful placement.
