Abdominal Aortic Aneurysm FAQ's

What is an abdominal aortic aneurysm?

An aneurysm is a localized, balloon-like expansion in a blood vessel, caused by weak vessel walls. The abdominal aorta refers to the part of the aorta, the artery that carries oxygen-rich blood from the heart to the legs, between the diaphragm and the legs. That is why the bulge that occurs in the abdominal aorta is called an abdominal aortic aneurysm.

Is an abdominal aortic aneurysm dangerous?

The weakened, bulging vessel walls are susceptible to rupture, a catastrophic event which causes severe bleeding and pain and is often fatal. Half of all untreated abdominal aortic aneurysms end in rupture and death within five years, making them the 13th leading cause of death in the United States. Leakage, rather than rupture, may occur causing blood to flow through the inner lining into the vessel wall, known as aortic dissection. In addition, blood clots may form in the aneurysm and travel to other arteries, where they may block blood flow. Other complications are an infection and blockage of the aorta.

Where does an abdominal aortic aneurysm occur?

Most aortic aneurysms occur in the abdomen, and most abdominal aortic aneurysms occur beneath the kidneys and may continue into the iliac or leg arteries.

Who is at risk for developing an abdominal aortic aneurysm?

Men are more likely than women to develop an abdominal aortic aneurysm. Being over the age of 60 also increases one's chances of developing abdominal aortic aneurysm.

What is the causes of an abdominal aortic aneurysm?

Atherosclerosis, the hardening and narrowing of arteries due to disease or fatty tissue accumulation, weakens vessel walls and is responsible for most abdominal aortic aneurysms. Other causes include the following:

  • Genetics
  • Vessel injury
  • Hypertension
  • Inflammation due to disease
  • Congenital deformity
  • Advanced syphilis
  • Fungal infection

What are the symptoms of an abdominal aortic aneurysm?

An abdominal aortic aneurysm may occur with no warning signs. Possible symptoms are as follows:

  • Deep abdominal pain, especially in the lower back
  • A pulsing sensation in the abdomen

Secondary symptoms of an abdominal aortic aneurysm may include:

  • Paleness
  • Rapid pulse
  • Dry skin/mouth
  • Excessive thirst
  • Anxiety
  • Nausea and vomiting
  • Light-headedness or fainting with upright posture
  • Excessive sweating
  • Clammy skin
  • Fatigue
  • Palpitations
  • Rapid heart rate (tachycardia) when rising to standing position
  • Impaired concentration
  • Shock

How is an abdominal aortic aneurysm diagnosed?

Abdominal aortic aneurysms may be detected by manual examination by a physician, X-rays, ultrasound, CT scans, MR imaging and aortography.

When is surgery recommended for an abdominal aortic aneurysm?

Surgery is recommended for an abdominal aortic aneurysm that is at great risk for rupture: those over six centimeters wide, and those four to six centimeters wide in patients otherwise in good health. Surgery is performed immediately on an aneurysm that threatens imminent rupture or have already ruptured, although a successful outcome is far less likely once the vessel has burst.

What does the surgery Involve?

Traditional surgery involves making an incision to open the abdomen, removing the aneurysm and replacing the excised vessel piece with synthetic tubing. Recent minimally invasive laparoscopic techniques require only small incisions, typically made to the femoral artery in the thigh, through which a thin tube with a camera is inserted so the surgeon can "see" inside the patient's body without the need for open surgery.

In the laparoscopic approach, a stent graft is inserted into one of the small incisions and guided up to the weak area of the artery with a catheter. Stent grafts are six-inch-long metal-mesh cylinders containing synthetic Dacron tubes. Once inside the artery they are expanded to fill the vessel, providing a strong new vessel wall and permitting uninterrupted blood flow. The aneurysm then generally shrinks around the stent graft as time passes.

What are the surgical risks of an abdominal aortic aneurysm?

Laparoscopic surgery offers a reduced risk of complications, but as with any surgery, there are risks of bleeding and infection. Additionally, surgery may result in:

  • Aortic rupture or dissection
  • Hypovolemic shock
  • Arterial embolism (blood clot)
  • Insufficient circulation
  • Kidney damage or failure
  • Myocardial infarction
  • Stroke

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