Abdominal aortic aneurysm
Definition :
Symptoms :
Abdominal aortic aneurysms often grow slowly and usually without symptoms, making them difficult to detect. Some aneurysms will never rupture. Many start small and stay small, although many expand over time. Some aortic aneurysms enlarge slowly, increasing less than half an inch (1.2 centimeters) a year.
Others expand at a faster rate, which increases the risk of rupture. How quickly an aortic aneurysm may enlarge is difficult to predict. As an aortic aneurysm enlarges, some people may notice: A pulsating feeling near the navel Tenderness or pain in the abdomen or chest Back pain When to see a doctor You should see your doctor if you have any of the symptoms listed above.
Anyone age 60 and older who has risk factors for developing an aortic aneurysm should consider regular screening for the condition. Men ages 65 to 75 who have ever smoked cigarettes should have a one-time screening for abdominal aortic aneurysm using abdominal ultrasound.
Men age 60 and older with a family history of abdominal aortic aneurysm should also consider screening. If you have a family history of aortic aneurysm, your doctor may recommend regular ultrasound exams to screen for the condition.
Causes :
Most aortic aneurysms occur in the part of your aorta that's in your abdomen. Although the exact cause of abdominal aortic aneurysms is unknown, a number of factors may play a role, including: Tobacco use.
Cigarette smoking and other forms of tobacco use appear to increase your risk of aortic aneurysms. In addition to the damaging effects that smoking causes directly to the arteries, smoking contributes to the buildup of fatty plaques in your arteries (atherosclerosis) and high blood pressure. Smoking can also cause your aneurysm to grow faster by further damaging your aorta.
High blood pressure. High blood pressure, especially if poorly controlled, increases the risk of developing an aortic aneurysm. This is because high blood pressure can damage and weaken your arteries. Infection in the aorta (vasculitis). In rare cases, aortic aneurysm may be caused by an infection or inflammation that weakens a section of the aortic wall. Aneurysms can develop anywhere along the aorta, but when they occur in the upper part of the aorta, they are called thoracic aortic aneurysms.
More commonly, aneurysms form in the lower part of your aorta, and are called abdominal aortic aneurysms. Rarely, an aneurysm can occur in between the upper and lower parts of your aorta. This type of aneurysm is called a thoracoabdominal aneurysm.
Complications
Tears in the wall of the aorta (dissection) and rupture of the aneurysm are the main complications of abdominal aortic aneurysm. A ruptured aortic aneurysm can lead to life-threatening internal bleeding. In general, the larger the aneurysm, the greater the risk of rupture.
Signs and symptoms that your aortic aneurysm has burst include:
Treatments and drugs
Here are the general guidelines for treating abdominal aortic aneurysms:
Small aneurysm. If you have a small aortic abdominal aneurysm — about 1.6 inches, or 4 centimeters (cm), in diameter or smaller — and you have no symptoms, your doctor may suggest a watch-and-wait (observation) approach, rather than surgery.
In general, surgery isn't needed for small aneurysms because the risk of surgery outweighs the risk of rupture. If you choose this approach, your doctor will monitor your aneurysm with periodic ultrasounds, usually every six to 12 months and encourage you to report immediately if you start having abdominal tenderness or back pain - potential signs of a dissection or rupture. Medium aneurysm.
A medium aneurysm measures between 1.6 and 2.2 inches (4 and 5.6 cm). It's less clear how the risks of surgery versus waiting stack up in the case of a medium-size aortic abdominal aneurysm. You'll need to discuss the benefits and risks of waiting versus surgery and make a decision with your doctor. Large, fast-growing or leaking aneurysm. If you have an aneurysm that is large (larger than 2.2 inches, or 5.6 cm) or growing rapidly (more than 0.5 cm over six months), you'll probably need surgery. In addition, a leaking, tender or painful aneurysm requires treatment.
There are two types of surgery for abdominal aortic aneurysms. Open-abdominal surgery to repair an abdominal aortic aneurysm involves removing the damaged section of the aorta and replacing it with a synthetic tube (graft), which is sewn into place, through an open-abdominal approach. With this type of surgery, it will likely take you several months to fully recover.
Endovascular surgery is a less invasive procedure sometimes used to repair an aneurysm. Doctors attach a synthetic graft to the end of a thin tube (catheter) that's inserted through an artery in your leg and threaded up into your aorta. The graft — a woven tube covered by a metal mesh support — is placed at the site of the aneurysm and fastened in place with small hooks or pins.
The graft reinforces the weakened section of the aorta to prevent rupture of the aneurysm. Recovery time for people who have endovascular surgery is shorter than for people who have open-abdominal surgery — about one or two weeks compared with six weeks for open surgery.
The options for treatment of your aneurysm will depend on a variety of factors, including location of the aneurysm, your age, kidney function and other conditions that may increase your risk for surgery or endovascular repair.
Definition :
Symptoms :
Abdominal aortic aneurysms often grow slowly and usually without symptoms, making them difficult to detect. Some aneurysms will never rupture. Many start small and stay small, although many expand over time. Some aortic aneurysms enlarge slowly, increasing less than half an inch (1.2 centimeters) a year.Others expand at a faster rate, which increases the risk of rupture. How quickly an aortic aneurysm may enlarge is difficult to predict. As an aortic aneurysm enlarges, some people may notice: A pulsating feeling near the navel Tenderness or pain in the abdomen or chest Back pain When to see a doctor You should see your doctor if you have any of the symptoms listed above.
Anyone age 60 and older who has risk factors for developing an aortic aneurysm should consider regular screening for the condition. Men ages 65 to 75 who have ever smoked cigarettes should have a one-time screening for abdominal aortic aneurysm using abdominal ultrasound.
Men age 60 and older with a family history of abdominal aortic aneurysm should also consider screening. If you have a family history of aortic aneurysm, your doctor may recommend regular ultrasound exams to screen for the condition.
Causes :
Most aortic aneurysms occur in the part of your aorta that's in your abdomen. Although the exact cause of abdominal aortic aneurysms is unknown, a number of factors may play a role, including: Tobacco use.
Cigarette smoking and other forms of tobacco use appear to increase your risk of aortic aneurysms. In addition to the damaging effects that smoking causes directly to the arteries, smoking contributes to the buildup of fatty plaques in your arteries (atherosclerosis) and high blood pressure. Smoking can also cause your aneurysm to grow faster by further damaging your aorta.
High blood pressure. High blood pressure, especially if poorly controlled, increases the risk of developing an aortic aneurysm. This is because high blood pressure can damage and weaken your arteries. Infection in the aorta (vasculitis). In rare cases, aortic aneurysm may be caused by an infection or inflammation that weakens a section of the aortic wall. Aneurysms can develop anywhere along the aorta, but when they occur in the upper part of the aorta, they are called thoracic aortic aneurysms.
More commonly, aneurysms form in the lower part of your aorta, and are called abdominal aortic aneurysms. Rarely, an aneurysm can occur in between the upper and lower parts of your aorta. This type of aneurysm is called a thoracoabdominal aneurysm.
Complications
Tears in the wall of the aorta (dissection) and rupture of the aneurysm are the main complications of abdominal aortic aneurysm. A ruptured aortic aneurysm can lead to life-threatening internal bleeding. In general, the larger the aneurysm, the greater the risk of rupture.
Signs and symptoms that your aortic aneurysm has burst include:
- Sudden, intense and persistent abdominal, chest or back pain
- Pain that radiates to your back or legs
- Sweatiness
- Clamminess
- Dizziness
- Low blood pressure
- Fast pulse
- Loss of consciousness
- Shortness of breath
Treatments and drugs
Here are the general guidelines for treating abdominal aortic aneurysms:
Small aneurysm. If you have a small aortic abdominal aneurysm — about 1.6 inches, or 4 centimeters (cm), in diameter or smaller — and you have no symptoms, your doctor may suggest a watch-and-wait (observation) approach, rather than surgery.
In general, surgery isn't needed for small aneurysms because the risk of surgery outweighs the risk of rupture. If you choose this approach, your doctor will monitor your aneurysm with periodic ultrasounds, usually every six to 12 months and encourage you to report immediately if you start having abdominal tenderness or back pain - potential signs of a dissection or rupture. Medium aneurysm.
A medium aneurysm measures between 1.6 and 2.2 inches (4 and 5.6 cm). It's less clear how the risks of surgery versus waiting stack up in the case of a medium-size aortic abdominal aneurysm. You'll need to discuss the benefits and risks of waiting versus surgery and make a decision with your doctor. Large, fast-growing or leaking aneurysm. If you have an aneurysm that is large (larger than 2.2 inches, or 5.6 cm) or growing rapidly (more than 0.5 cm over six months), you'll probably need surgery. In addition, a leaking, tender or painful aneurysm requires treatment.
There are two types of surgery for abdominal aortic aneurysms. Open-abdominal surgery to repair an abdominal aortic aneurysm involves removing the damaged section of the aorta and replacing it with a synthetic tube (graft), which is sewn into place, through an open-abdominal approach. With this type of surgery, it will likely take you several months to fully recover.
Endovascular surgery is a less invasive procedure sometimes used to repair an aneurysm. Doctors attach a synthetic graft to the end of a thin tube (catheter) that's inserted through an artery in your leg and threaded up into your aorta. The graft — a woven tube covered by a metal mesh support — is placed at the site of the aneurysm and fastened in place with small hooks or pins.
The graft reinforces the weakened section of the aorta to prevent rupture of the aneurysm. Recovery time for people who have endovascular surgery is shorter than for people who have open-abdominal surgery — about one or two weeks compared with six weeks for open surgery.
The options for treatment of your aneurysm will depend on a variety of factors, including location of the aneurysm, your age, kidney function and other conditions that may increase your risk for surgery or endovascular repair.
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