About Abdominal Aortic Aneurysm (AAA)

The abdominal aortic aneurysm (AAA) is one of the country’s most overlooked medical conditions.

It is a silent killer that takes the lives of approximately 15,000 American’s each year, most without warning or symptoms. The aorta is the heart’s main artery and is the major blood vessel that supplies blood to the body. It passes through the abdomen and splits into the two arteries that go into the legs. Two renal arteries branch from the aorta to feed the kidneys.

An aneurysm is a weakening and bulging of a vein or artery. It can occur anywhere in the body, but is most common in the aorta below the renal arteries. A healthy aorta is about 2 centimeters across in the abdomen. When an aneurysm develops and expands the aorta to 5 centimeters or greater, there is a 20% chance it could rupture. This is a health risk because a rupture may cause severe internal bleeding, which is often fatal. Only 10-20% of people who experience a ruptured abdominal aortic aneurysm will survive.

Abdominal aortic aneurysms often grow slowly and without symptoms, making them difficult to detect. Not all abdominal aortic aneurysms will reach the point of rupture. However, considering that this condition is life-threatening and usually asymptomatic, it is important to be screened if you qualify for the risk factors outlined later in this section.

Facts About Abdominal Aortic Aneurysms

Following are some facts about AAA’s:

  • Men are 4-5 times more likely than women to develop an abdominal aortic aneurysm.
  • Half of all persons with untreated abdominal aortic aneurysms die of rupture within 5 years.
  • Five percent of men over 60 develop an abdominal aortic aneurysm.
  • Abdominal aortic aneurysms are more common in Caucasians than in people of other races.
  • 80 to 90 percent of all ruptured aneurysms result in death.
  • Approximately one in every 250 people over the age of 50 will die of a ruptured AAA.
  • Ruptured abdominal aortic aneurysms are the 13th leading cause of death in the U.S.
  • Two-thirds of persons who experience a ruptured AAA didn’t know that they had one until it ruptured.

Risk Factors for Abdominal Aortic Aneurysms

Anyone can develop an abdominal aortic aneurysm, but it is most frequently seen in males over 60 with one or more risk factors.

The following are risk factors for developing an abdominal aortic aneurysm:

  • Male
  • Age 65-75
  • Smoking (lifetime consumption of 100 cigarettes or more)
  • First degree family history of AAA
  • High blood pressure
  • Obesity
  • Atherosclerosis
  • Diabetes

Reducing the Risk

Following are some of the ways you can reduce your risk of an abdominal aortic aneurysm:

  • Maintain a healthy body weight
  • Get enough exercise
  • Eat a healthy diet to prevent or reduce high blood pressure and high cholesterol
  • Stop smoking
  • Follow your healthcare provider’s instructions for controlling diabetes
  • Follow your healthcare provider’s instructions for stroke prevention

Symptoms of an AAA

Most people feel no symptoms. If you do experience symptoms they may consist of the following:

  • Pulsing feeling in the abdomen
  • Abdominal or lower back pain that may be constant or come and go

The following symptoms may indicate that an abdominal aortic aneurysm has ruptured:

  • Unexplained, severe pain in the abdomen or lower back that begins suddenly
  • Signs of shock, such as shaking, sudden weakness, dizziness, fainting, sweating, and rapid heartbeat
  • Nausea and vomiting
  • Paleness

If you develop these symptoms, you should get to a hospital or call 911 immediately.

Diagnosing an Abdominal Aortic Aneurysm

The most common test to diagnose AAA is ultrasound. Ultrasound of the abdomen is reliable, safe, and painless and is about 98% accurate in determining the size of the aneurysm. Abdominal aortic aneurysm screening ultrasounds are performed at Invision Sally Jobe by certified technologists.

Other methods for determining the size of the aneurysm are CT scan, MRI, or arteriogram. Your physician will determine the best screening method for you.

Treating this Condition

There are three treatment options available today for AAA. Your physician will factor in the size and growth rate of the AAA when determining the appropriate option for you.

  • Watchful Waiting: For small AAA’s which have a low incidence of rupture, having regular ultrasounds (usually every 6-12 months) under the care of a vascular disease specialist is advised. Your physician may also recommend medications or lifestyle changes to reduce your risk.
  • Surgical Repair: The most common treatment for a large aneurysm is an open surgical repair by a vascular surgeon. Surgery involves removing the damaged section of the aorta and replacing it with a synthetic tube. A ruptured abdominal aortic aneurysm may be repaired with emergency surgery; however, the risk is much higher and the chance of survival is lower.
  • Interventional Endovascular Repair: This is a minimally-invasive technique performed by an interventional team to insert and secure an abdominal aortic aneurysm stent graft in the aorta at the site of the aneurysm.
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