Abdominal Aortic Aneurysm

Whenever there is a weakening of the walls of a blood vessel, a balloon-like dilation (an aneurysm) can form. This frequently happens in the abdominal aorta and when it does there is risk for aortic rupture. While the direct cause of AAA is difficult to determine, many factors have been shown to increase your risk for developing AAA and/or experiencing a rupture in the aortic wall.

Potential causes and risk factors for developing AAA include:

• Family history. Aneurysms may be hereditary, making you as much as 12 times more likely to develop an abdominal aortic aneurysm if you have a first-degree relative that ever had AAA. Indeed, up to 25% of individuals treated for AAA also have a first-degree relative with AAA.
• Tobacco or nicotine use. Tobacco use (other smoking and chewing) is a major risk factor for developing abdominal aortic aneurysms. The more you do it, the greater the risk for initial development off AAA and higher your risk for aortic rupture.
• Age. Males greater than 50 years of age and women greater than 60 years of age are thought to be at a much higher risk of developing abdominal aortic aneurysms.
• Gender. Abdominal aortic aneurysms develop in males much more frequently than females.
• Trauma. Traumatic incidents (e.x., vehicle accidents) can cause an abdominal aortic aneurysm.
• Infections. Bacterial and fungal infections in the aorta may contribute to the development of abdominal aortic aneurysm.
• Inflammation and/or Vascular Disease. Inflammation and blood vessel disease in the aorta can lead to the development of AAA and increase your risk for aortic rupture.
• High blood pressure. You are at higher risk for developing AAA if you also have high blood pressure. Increased pressure on the aortic walls can weaken the aorta, leading to the development of an aneurysm.
• Atherosclerosis. You are at higher risk for developing AAA if you’ve experienced any hardening of the arteries.

Abdominal aortic aneurysms often develop slowly over longer periods.  In fact, no symptoms may even be present during the development of an AAA condition. While some individuals do experience symptoms as an abdominal aortic aneurysm develops, many aneurysms many not be detected until an actual rupture. Many patients describe sudden and severe back pain that brings them to their knees when an aortic rupture occurs.

Symptoms that may be experienced as an abdominal aortic aneurysm develops:

• Persistent, sudden, or sever back pain
• Pulsating sensation in or around the navel
• Persistent, sudden, or severe abdomen pain

Symptoms patients may experience when an abdominal aortic aneurysm ruptures:

• Sudden and severe back pain
• Sweating profusely
• Nausea and/or vomiting
• Dizziness or vertigo
• Rapid pulse
• Low blood pressure
• Pain in the back of the legs

If you experience any of the AAA rupture symptoms listed above, or you are at risk for abdominal aortic aneurysm based on a previous diagnosis by a qualified health care provider, please seek immediate medical attention.

The chances for survival after an abdominal aortic aneurysm ruptures is perhaps 25% or less. Therefore, if you meet certain criteria you should immediately request an abdominal ultrasound to see if you have an abdominal aortic aneurysm. Getting an ultrasound is both safe and accurate. Ultrasound is non-invasive and does not require the use of dyes, needles, or radiation.

Request an abdominal ultrasound if you meet ANY of the following criteria:

• You are a male over the age of 50 with a history of tobacco use, a family history of heart disease or other vascular disease, or high blood pressure
• You are a female over the age of 60 with high blood pressure, a history of tobacco use, or a family history of heart disease, aneurysm, or sudden unexplained death

If you know you are at risk due to family history, lifestyle habits, age, etc., you should not wait to request an abdominal ultrasound.  If an abdominal ultrasound detects that you DO have an abdominal aortic aneurysm you should request a referral to a vascular surgeon without delay. Vascular surgeons are specialists who are experts at managing and treating aneurysms. Your vascular surgeon will be able to give you far more detail about your condition than a general practitioner, as well as advise you regarding any additional tests needed.

NOTE: Medicare Part B (Medical Insurance) covers an abdominal aortic screening ultrasound once if you’re at risk. You’re considered at risk if you have a family history of abdominal aortic aneurysms, or you’re a man age 65-75 and have smoked at least 100 cigarettes in your lifetime.

Early detection and close follow-up are critical to the successful management of AAA.  Ultrasounds and CAT Scans are both considered effective ways to monitor the growth of abdominal aortic aneurysms when they are still relatively small.  However, once an aneurysm reaches around 5 centimeters in diameter, repair of the aneurysm is usually called for.

Your vascular surgeon will choose from several different methods for repairing aneurysms and your specific diagnosis will dictate the method selected.  Often times an aneurysm repair can be executed successfully using a minimally-invasive method that may only require small incisions in the groin area.  Each of the methods listed below has a high success rate and Dr. Tahara can explain each to you in greater detail.

The methods available for aneurysm repair at AVV include: 

Open Abdominal Surgery: This method involved the placement of a prosthetic graft and requires an incision in the abdomen. This method usually requires a hospital stay of 4 to 10 days and a total recovery time of 3 months.

Endovascular Aneurysm Repair (EVAR): This method is less invasive than open abdominal surgery and involves groin incisions. A catheter is guided in through the incisions and up to the aneurysm site. An expandable stent graft is positioned and sealed in place for permanent repair.

Regardless of the repair method selected, rest assured that Dr. Tahara and his staff give you full access to the latest technologies in vascular medicine.