What Is The Medical Treatment For Aortic Aneurysm
The treatment of this condition depends on the patient’s overall health, the size and location of the aneurysm, and whether the person is having symptoms. The risks and benefits of surgery for abdominal aortic aneurysms are different than those for thoracic aortic aneurysms and are listed below.
Abdominal aortic aneurysms
Abdominal aortic aneurysms are unlikely to rupture if they develop slowly, are less than 5.5 cm in diameter, and are causing no symptoms.
- In these cases, the risk of rupture over the next 5 years is considered negligible. The risks involved with surgery outweigh the risk of the aneurysm rupturing.
- Close monitoring of the aneurysm size is the proper treatment for most people.
- Ultrasound/CT scan every 6 to 12 months is the usual monitoring strategy. This may vary by individual patient and doctor.
- As the aneurysm enlarges to greater than 5.5 cm, surgical correction is the usual treatment of choice. However, small adults and large men may be judged as candidates for surgery with either less or greater aortic diameters, respectively, by their consulting surgeon.
- However, asymptomatic patients with inflammatory abdominal aortic aneurysm or abdominal aortic aneurysm that have caused symptoms of emboli, pain, or bowel obstruction usually require emergent repair regardless of aneurysm size.
- The risk of rupture of an abdominal aortic aneurysm greater than 2.7 inches in diameter in average-sized individuals is almost 20%.
Abdominal aortic aneurysm surgery
What Is An Abdominal Aortic Aneurysm
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 out like a small balloon if they become weak. This is called an abdominal aortic aneurysm when it happens in the part of the aorta thats in your abdomen.
AAAs dont always cause problems, but a ruptured aneurysm can be life-threatening. Therefore, if youre diagnosed with an aneurysm, your doctor will probably want to monitor you closely, even if they dont intervene right away.
What Are The Symptoms Of Abdominal Aortic Aneurysms
About 3 out of 4 abdominal aortic aneurysms don’t cause symptoms. An aneurysm may be found by X-ray, computed tomography scan, or magnetic resonance imaging that was done for other reasons. Since abdominal aneurysm may not have symptoms, it’s called the “silent killer” because it may rupture before being diagnosed.
Pain is the most common symptom of an abdominal aortic aneurysm. The pain associated with an abdominal aortic aneurysm may be located in the abdomen, chest, lower back, or groin area. The pain may be severe or dull. Sudden, severe pain in the back or abdomen may mean the aneurysm is about to rupture. This is a life-threatening medical emergency.
Abdominal aortic aneurysms may also cause a pulsing sensation, similar to a heartbeat, in the abdomen.
The symptoms of an abdominal aortic aneurysm may look like other medical conditions or problems. Always see your doctor for a diagnosis.
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How Are They Diagnosed
Since AAAs dont usually cause symptoms, healthcare providers often diagnose unruptured AAAs when theyre performing exams or tests for other health conditions. The following imaging exams may reveal an AAA:
- Abdominal ultrasound: An ultrasound is a quick, painless test that uses sound waves to create real-time images of the inside of your belly. Your healthcare provider may be able to see an aneurysm on an abdominal ultrasound.
- Computed tomography angiography : Your healthcare provider may do a CTA if they see an aneurysm on your ultrasound. You receive an injection of a contrast dye before a CT scan. Angiography helps your provider see the exact location, size and severity of the aneurysm.
What Questions Should I Ask My Doctor If I Have An Abdominal Aortic Aneurysm
You may want to ask your doctor:
- How big is the aneurysm?
- How can I reduce my risk of an aneurysm rupture?
- Is the aneurysm getting larger? If so, how quickly is it growing?
- What are the chances that the aneurysm will rupture?
A note from Cleveland Clinic
An abdominal aortic aneurysm is a potentially life-threatening condition. It develops when the wall of the main artery in your body develops a weak spot and bulges outward. If it ruptures, you can have massive internal bleeding. Its essential to find aneurysms before they rupture. Ask your doctor if youre a candidate for AAA screening and report any signs or symptoms right away.
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How Is An Aortic Aneurysm Diagnosed
There are lots of ways doctors might find an aneurysm:
- It might show up on an ultrasound scan before a baby is born.
- If a child shows signs of heart or artery problems, doctors will do tests to see what’s going on. A thoracic aortic aneurysm might show up when doctors do an ultrasound scan of the heart .
- If a child has an abdominal aneurysm, doctors and nurses might notice it during a physical exam. They will then confirm the problem by doing an ultrasound scan.
- Aneurysms can run in families. If your family has a genetic condition that causes them, doctors might test your child for aneurysms.
Symptoms Of An Unruptured Abdominal Aortic Aneurysm
Abdominal aortic aneurysms are slow-growing and often do not cause symptoms, making them difficult to notice. Many never get big enough to have any effect. However, some expand more quickly, increasing the risk of rupture. Because a ruptured aneurysm puts your life in jeopardy, it is best to monitor any aneurysm that has been detected carefully for growth.
If you do have symptoms before the aneurysm ruptures, they may include tenderness and pain in the area just below your navel. You may feel a pulsing as well, like a heartbeat in your abdomen.
Experiencing sudden or severe pain in your lower back may also be a sign of abdominal aneurysm. Loss of appetite or upset stomach sometimes accompanies these symptoms.
- Abdominal aortic aneurysms are slow-growing and often do not cause symptoms, making them difficult to notice.
- If you do have symptoms before the aneurysm ruptures, they may include tenderness and pain in the area just below your navel.
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How Can I Prevent Abdominal Aortic Aneurysms
Sometimes you cant prevent AAA, especially if you have a family history of the condition. But you can talk to your doctor right away if you experience any symptoms. Early detection and the right treatment may prevent the aneurysm from getting larger or rupturing.
You can also control many of the risk factors by:
- Stopping smoking.
- Exercising and eating a healthy diet.
- Managing your weight, blood pressure and cholesterol.
- Avoiding drinking too much alcohol.
Reducing Your Risk Of An Abdominal Aortic Aneurysm
There are several things you can do to reduce your chances of getting an AAA or help stop one getting bigger.
If you have a condition that increases your risk of an AAA, such as high blood pressure, your GP may also recommend taking tablets to treat this.
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Can An Aortic Aneurysm Be Treated At Home
No. An aortic aneurysm is a medical emergency. Call 911 or go to the Emergency Department immediately if you suspect that you or someone with you is having an aortic aneurysm.
Do not try to treat an aortic aneurysm anyone at home or to wait and see if the symptoms will resolve. Aortic aneurysm requires immediate, expert medical attention and rapid diagnosis before ruptures, which can lead to death. Symptoms that suggest internal bleeding are:
- Severe chest
- Back pain
When To See A Doctor
Many AAAs will not cause any symptoms and might not require treatment. However, it is important to see a doctor for any signs of an aneurysm. A doctor will help determine the risk of rupture and monitor the situation.
Males who are 65 years of age or older and have ever smoked should get an ultrasound screening for AAA.
It is essential to seek immediate medical attention if the aneurysm causes any symptoms, including persistent and severe back or stomach pain.
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Abdominal Aortic Aneurysm Repair
AAA – open Repair – aortic aneurysm – open
Open abdominal aortic aneurysm repair is surgery to fix a widened part in your aorta. This is called an aneurysm. The aorta is the large artery that carries blood to your belly , pelvis, and legs.
An aortic aneurysm is when part of this artery becomes too large or balloons outward.
How Are Abdominal Aortic Aneurysms Treated
Treatment depends on the size of the aneurysm. Aneurysms that are less than five centimeters in diameter have a low risk of rupturing and may not need treatment right away. Your healthcare provider may recommend watchful waiting, which includes:
- Getting ultrasounds every few months to make sure the aneurysm isnt getting bigger.
- Making lifestyle adjustments, such as exercising, not smoking, eating a healthy diet, avoiding alcohol and maintaining a healthy weight.
- Taking medication to lower your blood pressure.
No known medication, supplement or other treatment can shrink an aneurysm once it has formed. The goal of the measures above is to keep your aneurysm from growing and identify which people have a high risk of rupture, meaning they would benefit from surgery to treat their AAA.
Surgery for abdominal aortic aneurysm
Aneurysms that are larger than five centimeters across or that show signs of rupturing need surgery. Depending on the size, location and complexity of your aneurysm, your healthcare provider may recommend:
After either type of aneurysm repair, its critical that you continue to follow up with your provider for surveillance of your repaired aorta. This again can be done with ultrasound or CT.
What are the risks of surgery?
Minimally invasive surgery has a lower chance of complications than open surgery, but risks still include:
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Diagnosing An Abdominal Aortic Aneurysm
AAAs that havent 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 its rigid or contains a pulsing mass. They may also check the blood flow in your legs or use one of the following tests:
What Causes An Aaa
Doctors dont know exactly what causes an AAA. Weaker aorta walls increase your chance of developing an aneurysm. There are many conditions that can weaken the walls of the aorta. These include aging, smoking, and high blood pressure. If any of the following factors apply to you, you are at higher risk of having an AAA.
- Being male. Men are more likely than women to develop an AAA.
- AAAs are more common in people age 65 or older.
- Personal history. If you have had aneurysms of any kind, you are at greater risk of an AAA.
- Smoking damages and weakens the aorta walls.
- High blood pressure. Having high blood pressure weakens the walls of your aorta.
- Family history. If any family members have had AAAs, you are at higher risk. You also could get an AAA before you are 65.
Talk to your doctor if you have a higher risk for an AAA, or if you have any of the symptoms.
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What Are The Types Of Aortic Aneurysm
A thoracic aortic aneurysm happens in the chest. Men and women are equally likely to get thoracic aortic aneurysms, which become more common with increasing age.4
Thoracic aortic aneurysms are usually caused by high blood pressure or sudden injury. Sometimes people with inherited connective tissue disorders, such as and Ehlers-Danlos syndrome, get thoracic aortic aneurysms.
Signs and symptoms of thoracic aortic aneurysm can include the following:
- Sharp, sudden pain in the chest or upper back
- Shortness of breath
- Trouble breathing or swallowing
An abdominal aortic aneurysm happens below the chest. Abdominal aortic aneurysms happen more often than thoracic aortic aneurysms.
Abdominal aortic aneurysms are more common in men and among people age 65 and older. Abdominal aortic aneurysms are more common among white people than among black people.5
Abdominal aortic aneurysms are usually caused by atherosclerosis , but infection or injury can also cause them.6
Abdominal aortic aneurysms often dont have any symptoms. If an individual does have symptoms, they can include the following:
- Throbbing or deep pain in the back or side
- Pain in the buttocks, groin, or legs
Articles On Aortic Aneurysm
The aorta is the largest blood vessel in the body. Although your aorta is a tough, durable workhorse, sometimes its walls can weaken and bulge in what is called an aortic aneurysm. This could cause a leak that spills blood into your body.
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What Can Parents Do
Kids often don’t show signs of an aortic aneurysm. There are several things you can do to protect your child from having an emergency:
- Take your child to all well-child checkups.
- If doctors are watching your child for an aneurysm, go to all follow-up visits and testing.
- If your child needs medicine, give it as prescribed. Renew prescriptions before they run out. Ask the pharmacist or your doctor if you’re not sure how to give a medicine.
- Tell your doctor if other people in your family have aneurysms.
- If your child has a genetic condition that causes aneurysms, ask about getting other family members tested. This can reveal an aneurysm before it causes problems.
- If your child had an aneurysm repaired, there’s still a chance of having another one. Follow your doctor’s instructions about setting up regular ultrasounds, MRIs, or CT scans.
Treatments For An Abdominal Aortic Aneurysm
The recommended treatment for an AAA depends on how big it is.
Treatment is not always needed straight away if the risk of an AAA bursting is low.
Treatment for a:
- small AAA ultrasound scans are recommended every year to check if it’s getting bigger you’ll be advised about healthy lifestyle changes to help stop it growing
- medium AAA ultrasound scans are recommended every 3 months to check if it’s getting bigger you’ll also be advised about healthy lifestyle changes
- large AAA surgery to stop it getting bigger or bursting is usually recommended
Ask your doctor if you’re not sure what size your AAA is.
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Treatment Of A Ruptured Abdominal Aortic Aneurysm
Rupture or impending rupture of an abdominal aortic aneurysm requires emergency open surgery or placement of an endovascular stent graft. The risk of death during an emergency repair of a ruptured aneurysm is about 50%. The risk of death may be lower with endovascular stent graft placement. When an aneurysm ruptures, the kidneys may be affected because their blood supply is disrupted or because blood loss results in shock Shock Shock is a life-threatening condition in which blood flow to the organs is low, decreasing delivery of oxygen and thus causing organ damage and sometimes death. Blood pressure is usually low… read more . If kidney failure develops after repair of a ruptured aneurysm, the chances of survival are very poor.
What Is Aortic Aneurysm
An aortic aneurysm is a balloon-like bulge in the aorta, the large artery that carries blood from the heart through the chest and torso.
Aortic aneurysms can dissect or rupture:
- The force of blood pumping can split the layers of the artery wall, allowing blood to leak in between them. This process is called a dissection.
- The aneurysm can burst completely, causing bleeding inside the body. This is called a rupture.
- Dissections and ruptures are the cause of most deaths from aortic aneurysms.
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What Are The Risk Factors For Aaa Rupture
When the abdominal aorta, the largest blood vessel in the human body, develops a bulge or swelling due to a weakening of the wall, this is called an aneurysm. An abdominal aortic aneurysm often has no symptoms, and its rupture is a very serious complication.
Aside from the risk factors that cause AAA in the first place, the risk of a ruptured abdominal aortic aneurysm depends on several factors:
- The size of the aneurysm: An abdominal aortic aneurysm with a diameter measuring more than 4 cm is more likely to rupture.
- Aneurysm diameter growth rate: Faster than 0,5 cm in six months.
- Sex women are three times more likely to have an abdominal aortic aneurysm rupture than men.
- High blood pressure.
- Continued smoking.
The numbers weve mentioned here are used as a threshold in aortic surgery. For example, although aneurysms smaller than 5.5 cm are statistically less likely to rupture, due to these differences, it is up to the surgeon to ultimately evaluate the risk of aneurysm rupture in each patient. The surgeon can then decide if surgical treatment is in order, by calculating the benefit vs risk ratio. Its also important to mention that even small aneurysms in women are more likely to burst than in men.
Who Gets Abdominal Aortic Aneurysms Are They Genetic
Abdominal aortic aneurysms tend to occur in white males over the age of 60. In the United States, these aneurysms occur in up to 3.0% of the population. Aneurysms start to form at about age 50 and peak at age 80. Women are less likely to have aneurysms than men and African Americans are less likely to have aneurysms than Caucasians.
There is a genetic component that predisposes one to developing an aneurysm the prevalence in someone who has a first-degree relative with the condition can be as high as 25%.
Collagen vascular diseases that can weaken the tissues of the aortic walls are also associated with aortic aneurysms. These diseases include Marfan syndrome and Ehlers-Danlos syndrome.
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