Abdominal Aortic Aneurysms (AAA)
What is an abdominal aortic aneurysm?
The aorta is the body’s largest blood vessel carrying blood from the heart to the rest of the body. It extends from the chest to the abdomen, and then branches into the iliac arteries, which carry blood to the lower body and legs.
With aging and other changes, a section of the aorta can weaken and begin to bulge. This bulge is called an “aneurysm.” If it occurs in the chest cavity, it is called a thoracic aortic aneurysm; if it’s in the abdomen, it is an abdominal aortic aneurysm (AAA). Its normal diameter is about one inch or less. Small aneurysms rarely burst and are not considered serious health risks. But if the AAA enlarges over time, the aorta’s walls stretch and become thinner, and the risk increases. Weakened sections of the aortic wall may no longer be able to support the force of blood flow.
AAAs are called “silent killers” because they can cause fatal ruptures with no prior symptoms. They are often caused by arterial disease, which can be limb- and life-threatening.
AAAs occur in five to seven percent of Americans over age 60. Men are at least four times more likely to have an AAA than women. Approximately one in every 250 people over age 50 will die of a ruptured AAA. However, if AAA is diagnosed early, it can be successfully treated and rupture prevented.
What are some symptoms of AAA?
In many cases, patients have no symptoms. For those who do have symptoms, the most common symptom is pain, from mild to severe pain or tenderness in the mid- or upper abdomen or lower back. Some patients feel the AAA as a throbbing mass in their abdomen.
AAAs are frequently discovered during examinations being done for other reasons, or during medical tests such as a CT Scan or ultrasound.
Symptoms of a ruptured aneurysm include:
- Severe, stabbing pain that begins suddenly and feels like a knife
- Paleness
- Rapid pulse
- Dry mouth/skin and excessive thirst
- Anxiety
- Nausea and vomiting
- Lightheadedness or fainting
- Excessive sweating or clammy skin
- Shock
What causes an AAA?
The most common cause is atherosclerosis (often called hardening of the arteries). This is a gradual process in which cholesterol and scar tissue build up to form “plaque” that weakens the blood vessels’ walls, making them more vulnerable to an aneurysm. Also, over time, vascular disease, injury or a hereditary tissue defect in the arterial wall can weaken the aorta. Blood pressure against the weakened area can cause the aorta to swell.
Other risk factors for AAA include:
- High blood pressure
- Family history
- Smoking
What is the treatment for AAA?
If you have a small aneurysm, your physician may recommend regular check-ups to monitor it. If it enlarges and there is a risk of bursting, treatment may be necessary.
In open surgical repair, the damaged section of the aorta with the aneurysm is replaced with a fabric tube called a “graft,” which is sewn in place and acts as a replacement vessel.
In some cases, a patient may be a candidate for a newer non-surgical treatment called an endovascular (inside a blood vessel) or “stent-graft” repair, which is a less invasive procedure. Through small incisions, a graft is inserted and positioned inside the aorta, sealing off the aneurysm, creating a new path for blood flow. Stent-graft repair treatment is offered at Mercy’s Katz Cardiovascular Center.
For more information on AAA and other circulatory conditions from the Society of Interventional Radiology, click here www.sirweb.org or from the Vascular Disease Foundation at www.vdf.org
