What Is Abdominal Aortic Aneurysm?

An abdominal aortic aneurysm (AAA) is an enlargement of the lower part of the aorta. The aorta is your largest artery. In your abdomen, the aorta splits into the iliac arteries, which carry blood to your legs and lower areas of your body.

Arteries are part of your circulation system that brings oxygenated blood to all parts of the body. As we age, plaque builds up on the inside of our arteries, which can weaken the artery walls. When the wall of the artery weakens, an enlargement can occur, which is known as an aneurysm.

There is reason to be concerned if you have an abdominal aortic aneurysm: If it becomes too large, it could rupture, which is extremely dangerous and can potentially cause life-threatening bleeding.

Baptist Health is known for advanced, superior care for patients with heart disease and the diagnosis, management and treatment of abdominal aortic aneurysms. You will appreciate timely appointments and a professional, friendly atmosphere where we take time to listen to your concerns. At Baptist Health, you have access to the region’s most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health.

Signs and Symptoms

An abdominal aortic aneurysm can be slow to grow and exhibit no symptoms. That’s why regular checkups are important. If an aneurysm ruptures, symptoms like these may be noticed:

• Pain in the chest, abdomen, or lower back, possibly spreading to the groin, buttocks, or legs (NOTE: The pain may be deep, aching, gnawing, and/or throbbing, and may last for hours or days. It is generally not affected by movement, although certain positions may be more comfortable than others.)
• A pulsating sensation in the abdomen near the navel
• Pain in the abdomen, groin or back
• A cold foot or a black or blue painful toe
• Clammy skin
• Dizziness or fainting
• Nausea or vomiting
• Rapid heart rate

Causes

Abdominal aortic aneurysm causes can include:

• Being overweight or obese
• Buildup of fat and plaque on the lining of the arteries
• High blood pressure
• Infection in the aorta
• Tobacco use

Risk Factors

Risk factors that could contribute to an abdominal aortic aneurysm include:

Age: Most abdominal aortic aneurysms occur in people over age 65.

Gender: Men develop abdominal aortic aneurysms more often than women.

Family history: People with a family history of aneurysms tend to develop them at a younger age and are at higher risk of a rupture.

Prevention

While some risk factors like age and heredity cannot be controlled, there are ways you can help to prevent an abdominal aortic aneurysm:

Practice good heart health: Watch what you eat, exercise and avoid smoking,

Take your medications as prescribed: If you have high blood pressure, high cholesterol or diabetes, be certain to take your prescribed medications as directed.

Get scanned: If you are over 65 and at a higher risk for abdominal aortic aneurysm your physician may suggest a simple screening test. It’s a painless and fast ultrasound that can determine if an aneurysm is forming.

Diagnosis

Early diagnosis is critical to manage an abdominal aortic aneurysm. To determine if someone has an abdominal aortic aneurysm, we use advanced technology to effectively diagnose, inform treatment and carefully monitor the condition. Diagnostic testing procedures can include:

Abdominal ultrasound: During this test, sound waves are transmitted through the body tissues of the abdomen. The echoes from the sound waves are converted into video or photographic images.

Angiogram:  A thin tube (catheter) is inserted into a blood vessel and dye is injected to make the blood vessel visible during an X-ray. This can show any blood clots or other blood vessel issues.

CT Scan: X-rays and computers are used to create images of the aorta, heart and blood vessels. This provides a more detailed picture than an ultrasound.

Magnetic resonance imaging (MRI): A large magnet, radio waves and a computer are used to produce pictures of the heart and blood vessels.

Prognosis

Prognosis is usually positive when an abdominal aortic aneurysm is treated before it ruptures.

Treatment

Abdominal aortic aneurysm treatment depends on the aneurysm’s size, location and your overall health. Once an abdominal aortic aneurysm has been diagnosed, our goal is to develop an individualized plan to treat it so it will not develop to a dangerous level and rupture. Depending on the size of the aneurysm, treatment can include:

Medication

If the size of the abdominal aortic aneurysm is small, medication may be used to slow its growth rate. It’s important to monitor your blood pressure and take your blood pressure medication as prescribed. A statin medication, which lowers cholesterol and can help keep your blood vessels healthy, may also be prescribed. Regular testing is an important way to keep a watchful eye on the aneurysm.

Surgery

The most effective treatment for a larger, fast-growing or leaking aneurysm is surgery. Prior to surgery, you may have a computed tomographic angiogram (CTA), an imaging study that provides detailed images of the aneurysm and surrounding blood vessels. During surgery, the weakened section of the vessel will be removed and replaced with a graft of artificial material.

Minimally Invasive Procedures

Depending on the location and appearance of the aneurysm and your health, you may be recommended for a minimally invasive procedure called endovascular surgery. During this procedure, a small catheter is placed in groin through two small incisions. An endovascular graft is threaded through the catheter to your heart and positioned inside the diseased section of the aorta. The stent acts as a liner to divert blood flow away from the aneurysm.

Recovery After Surgery

Depending upon how your body heals, you will be in the hospital for up to 10 days after open abdominal aortic aneurysm surgery and it may be three to six months before you feel able to fully resume your normal activities. After endovascular surgery, you will be in the hospital for a few days and it may be four to six weeks before you fully recover.

Complications

If an abdominal aortic aneurysm is not diagnosed and treated, the aneurysm could cause serious health problems. Those problems can include:

Rupture: Because the aorta is the main supplier of blood to the body, a ruptured abdominal aortic aneurysm could cause life-threatening bleeding. This creates an emergency surgical situation. Only about one in 5 people survive a ruptured abdominal aortic aneurysm.

Blood clots: Blood clots can weaken the heart and affect its ability to pump blood through the body. If a blood clot breaks loose, it could block a blood vessel anywhere in your body.