Abdominal Aortic Aneurysm
What is Abdominal Aortic Aneurysm (AAA)?
The aorta is the most significant blood vessel in the body. Its thickness is similar to a garden hose. This vessel is responsible for carrying blood from the heart to the head, and arms, as well as down through the abdomen and pelvis to the legs. An abdominal aortic aneurysm is a condition in which the part of the aorta that travels through the abdomen has weakened. The walls of the aorta become extended like a balloon as a result of weakness in the vessel wall.
Symptoms of Abdominal Aortic Aneurysm
An abdominal aortic aneurysm is called a “silent” problem because it may grow over time without causing initial symptoms. This aneurysm may never rupture and may always stay small. Sometimes, the abdominal aortic aneurysm expands more quickly. The rate of expansion is not something that we can predict.
If the aneurysm grows larger, symptoms such as deep, persistent pain in the abdomen, back pain, or a pulsating or vibrating sensation near the navel may develop. The sudden onset of any of these symptoms requires emergency medical care.
Risk Factors For AAA
Science has not determined an exact cause of abdominal aortic aneurysm. However, there are several contributing factors. These include:
- High blood pressure, which can weaken the walls of the aorta.
- Atherosclerosis, or hardening of the arteries, fills the lining of the blood vessel with fatty substances.
- Vascular disease in the aorta, which cause inflammation.
- Infection in the aorta caused by fungus or bacteria.
- Trauma to the chest or abdominal cavity, such as an auto accident.
- Tobacco use, which can weaken the walls of the aorta.
- Heredity. Having a close relative who has had an AAA.
- Males or more likely to develop this than females
- Older age
diagnosing Abdominal Aortic Aneurysm
Many abdominal aortic aneurysms are detected during a medical examination conducted for other reasons. For instance, a general physical exam may reveal an abdominal bulge. This type of aneurysm may also be detected during medical tests such as chest x-ray or abdominal ultrasound.
If symptoms, examination findings, or medical history indicate a potential abdominal aortic aneurysm, your doctor may order specialized tests. These include:
- Abdominal ultrasound. This non-invasive, painless imaging exam is conducted in a radiology facility or hospital. After applying gel to the abdomen, the provider runs a transducer across the skin. This sends ultrasound waves into the abdominal cavity, which will bounce off of structures to produce an image that is displayed on the computer monitor.
- CT scan. Computerized tomography, or CT, is conducted in a donut-shaped machine. The patient lies comfortably on an exam table, and the table is moved through the machine as cross-sectional images are captured.
- MRI, or magnetic resonance imaging, can detect the size and location of an aneurysm. This test is somewhat similar to a CT scan, but the tube-like machine is longer. The table slides into the machine and remains in place throughout the test. The doctor obtains images using a magnetic field and radio wave energy.
Other tests may be done before repair of the artery:
- Arterial Doppler study: Blood flow in the legs is measured with a special probe and blood pressure cuffs placed on the leg
- Arteriography: This test creates an x-ray image showing the blood flow through the aorta and oher arteries. Contrast fluid is used for this test.
AAA & Arterial Disease
If you have an AAA, it’s possible that you also have disease in other arteries. If so, you are at risk for a heart attack, stroke, and vascular problems in the legs and other areas of the body. Your provider may recommend that you be screened for these conditions.
Complications of Abdominal Aortic Aneurysm
Doctors are careful to monitor or treat abdominal aortic aneurysm to diminish the risk of complications. The primary complication to avoid is aneurysm rupture, in which the “balloon” of weakened aortic tissue breaks open, allowing extensive internal bleeding. Another complication that may occur includes aortic dissection or tears in the layers of the aortic wall. Finally, blood clots may form around the aortic aneurysm. If one or more blood clots break free, it can create a blockage in any blood vessel of the body.
Treatment for Abdominal Aortic Aneurysm
An abdominal aortic aneurysm may be treated with one of two surgical techniques, endovascular repair or open surgery. Both methods involve placing an artificial graft inside the damages artery. Each type of procedure has risks and benefits that you should discuss with your doctor.
Endovascular Aneurysm Repair
Endovascular aneurysm repair is a technique that involves two small incisions in the groin, through which a graft stent is inserted. Your surgeon uses x-ray guidance to move the graft through the arteries toward the damaged part of the aorta. The catheters are then used to place the graft in position. Once the graft is in position, the surgeon expands it. Metal springs or hooks hold it in place above and below the aneurysm. This stent is situated within the aneurysm to preserve blood flow and prevent aneurysm rupture. No aortic tissue is removed in this surgical procedure.
After the procedure, some tests may be done to check the graft. The incisions in your groin will then be closed. You will be closely monitored after the procedure. After endovascular repair, you’ll need follow-up tests often. Your first follow-up visit will be about a week after surgery. At this time, imaging tests will be done to check the graft. In most cases, imaging tests are needed every 3-6 months for the first 2 years. After that, you will likely have yearly tests.
Open Abdominal Surgery
Open abdominal surgery involves an incision on the abdomen to gain access to the interior space. Your surgeon will gently move aside the organs to locate the aorta. The aorta is clamped to stop blood flow. The surgeon then opens the aneurysm and clears any blood clot. The graft is sewn to the aorta above and below the aneurysm. Some of the aorta wall may be removed. This helps a snug fit when the aorta is wrapped around the graft. The aorta is then sewn together, helping to protect the graft. The incision site is then closed.
Recovery after Surgery for AAA
Regardless of the type of surgery performed for AAA, the patient may remain in the hospital for a few days. At home, recovery may continue at a relatively slow pace. Soreness at the incision site of an open AAA repair diminishes gradually over 5 to 10 days. Discomfort after either surgical technique is manageable with prescription pain medication. Patients should expect to feel more fatigued than usual during their recovery. Rest and a good support system are vital to healing and general well-being. After 6 to 8 weeks, patients will be more comfortable and can resume more activities.
We provide detailed instructions for post-surgical healing and remain available to our patients to answer questions that may arise.
Schedule a Consultation
If you are suffering from Abdominal Aortic Aneurysm (AAA) and are seeking treatment, contact our office. Call us at 775-323-3000 to schedule a consultation. Our practice serves Reno, NV and surrounding areas.