Abdominal Aortic Aneurysm (AAA)
What Is an abdominal aortic aneurysm (AAA)?
The aorta is the largest blood vessel in the human body; it carries blood from your heart, up to your head and arms, and down to your abdomen, legs, and pelvis. The walls of the aorta can swell or bulge if they become weak; when it happens in the part of the aorta that’s in your abdomen, it is called an abdominal aortic aneurysm (AAA).
AAAs don’t always cause problems, but a ruptured aneurysm can be extremely dangerous, and even life-threatening. Therefore, if you are diagnosed with an aneurysm, your doctor will probably want to monitor you closely, even if they don’t intervene right away.
Risk Factors of AAA
AAAs are more likely to occur if you:
- Are male
- Are obese/overweight
- Are over the age of 60
- Have a family history of heart conditions and diseases
- Have high blood pressure, especially if you’re between 35 and 60 years old
- Have high cholesterol or fatty buildup in the blood vessels (atherosclerosis)
- Live a sedentary lifestyle
- Have had trauma to your abdomen or other damage to your midsection
- Smoke tobacco products
Causes of an Abdominal Aortic Aneurysm
The cause of AAAs is currently unknown. However, certain factors have been shown to increase your risk for them. They include:
Smoking
Smoking can directly damage the walls of your arteries, making them more likely to bulge. It can also increase your risk of high blood pressure.
High blood pressure (hypertension)
Blood pressure refers to the level of pressure on the walls of your blood vessels. High blood pressure can weaken the walls of your aorta, making an aneurysm more likely to form.
Vascular inflammation (vasculitis)
Serious inflammation within the aorta and other arteries can occasionally cause AAAs. This happens very rarely.
Aneurysms can form in any blood vessel in your body. However, AAAs are considered particularly serious because of the size of the aorta.
Symptoms of AAA
Most aneurysms have no symptoms unless they rupture. If an AAA does rupture, you may experience one or more of the following symptoms:
- Sudden pain in your abdomen or back
- Pain spreading from your abdomen or back to your pelvis, legs, or buttocks
- Clammy or sweaty skin
- Increased heart rate
- Shock or loss of consciousness
Call your doctor immediately if you experience any of these symptoms. A ruptured aneurysm can be life-threatening.
Diagnosis of an Abdominal Aortic Aneurysm
AAAs that haven’t ruptured are most often diagnosed when a doctor is scanning or examining your abdomen for another reason.
If your doctor suspects that you may have one, they will feel your stomach to see if it’s rigid or contains a pulsing mass. They may also check the blood flow in your legs or use one of the following tests:
- CT scan of the abdomen
- Abdominal ultrasound
- Chest X-ray
- Abdominal MRI
Treatment of AAA
In order to repair or remove the damaged tissue, your doctor may perform surgery (either open surgery, or endovascular surgery, depending on your overall health and the type of aneurysm). The surgery performed will depend on your overall health and the type of aneurysm.
Open Abdominal Surgery
Open abdominal surgery is used to remove damaged areas of your aorta. It’s the more invasive form of surgery and has a longer recovery time, but it is often necessary, especially if your aneurysm is very large or has already ruptured.
Endovascular Surgery
Endovascular surgery is a less invasive form of surgery that involves using a graft to stabilize the weakened walls of your aorta.
For a small AAA that’s less than 5.5 centimeters wide, your doctor may decide to monitor it regularly instead of performing surgery. Surgery has risks, and small aneurysms generally don’t rupture.
Complications of an Abdominal Aortic Aneurysm
Complications of an Abdominal Aortic Aneurysm include:
- Aortic Dissection (Tears in one or more of the layers of the wall of the aorta)
- Ruptured Aortic Aneurysm
- Life-threatening internal bleeding
Outlook of AAA
If your doctor recommends open abdominal surgery, it may take up to six weeks to recover. Recovery from endovascular surgery only takes two weeks.
The success of surgery and recovery greatly depends on whether or not the AAA is found before it ruptures. Prognosis is usually good if the AAA is found before it ruptures.