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Abdominal aortic aneurysmDefinition An aneurysm is when a blood vessel becomes abnormally large or balloons outward. The abdominal aorta is a large blood vessel that supplies blood to your abdomen, the pelvis, and legs. Causes, incidence, and risk factors The exact cause is unknown, but risk factors for developing an aortic aneurysm include high blood pressure, smoking, high cholesterol, and obesity. An abdominal aortic aneurysm can develop in anyone, but it is most frequently seen in people over 50 with one or more risk factors. The larger the aneurysm, the more likely it is to rupture. When an abdominal aortic aneurysm ruptures, it is a true medical emergency. Aortic dissection occurs when the innermost lining of the artery tears and blood leaks into the wall of the artery. Symptoms Aneurysms develop slowly over many years and often have no symptoms. If an aneurysm expands rapidly, tears open (ruptured aneurysm), or blood leaks along the wall of the vessel (aortic dissection), symptoms may develop suddenly. The symptoms of rupture include:
Signs and tests Your doctor will examine your abdomen. The exam also will include an evaluation of pulses and sensation in your legs. Abdominal aortic aneurysm may be diagnosed with these tests: Treatment If the aneurysm is small and there are no symptoms (for example, if it was discovered during a routine physical), your doctor may recommend periodic evaluation. This usually includes a yearly ultrasound, to see if the aneurysm is getting bigger. Aneurysms that cause symptoms usually require surgery to prevent complications. Surgery is recommended for patients with aneurysms bigger than 5 cm in diameter and aneurysms that rapidly increase in size. The goal is to perform surgery before complications develop. There are two approaches to surgery. In a traditional (open) repair, a cut is made in your abdomen. The abnormal vessel is replaced with a graft made of synthetic material, such as Dacron. The other approach is called endovascular repair. Thin, hollow tubes called catheters are inserted through arteries in your groin. These tubes allow the grafts to be placed without making a large cut in your abdomen. In addition, you may recover sooner. However, not all patients with abdominal aortic aneurysms are candidates for endovascular repair. Expectations (prognosis) The outcome is usually good if an experienced surgeon repairs the aneurysm before it ruptures. However, less than 50% of patients survive a ruptured abdominal aneursym. Complications
Calling your health care provider Go to the emergency room or call 911 if you develop severe abdominal pain or any of the other symptoms of an aneurysm. Prevention Exercise, eat well, and avoid tobacco to reduce the risk of developing aneurysms. Illustrations
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