The aorta is the largest artery in your body and is vital in delivering oxygen-rich blood away from your heart. The aorta has two sections, the thoracic aorta located in the chest, and the abdominal aorta located in your abdomen. The abdominal aorta delivers the blood to the lower part of your body including the legs, GI tract and kidneys.

An Abdominal Aortic Aneurysm (AAA) occurs when a weak area of the abdominal aorta expands or bulges. Left untreated, an AAA will continue to enlarge and may eventually rupture which can cause severe internal bleeding, shock and even death. An aortic aneurysm can also lead to clots or debris that can travel to other areas in the body and block circulation, causing severe pain and other serious problems, such as limb loss. 

When diagnosed early an AAA can be treated, or even cured, with highly effective treatments.

Risk Factors

An aneurysm may be caused by an inflammation in the aorta, which may cause the strength of the aorta walls to weaken. Atherosclerosis (hardening of the arteries) and risk factors for it, such as high blood pressure or smoking, may be contributing factors for inflammation in the aorta. Additional AAA risk factors include a family history of AAA, being a man older than 60 years, and chronic lung disease. 

Symptoms

Most people do not experience symptoms but if they do, they can be one or more of the following:

• A pulsing feeling in abdomen, similar to a heartbeat
• Severe, sudden pain in abdomen or lower back
• Pain, discoloration or sores on feet (this is a rare symptom)

A burst aneurysm may cause sudden intense weakness, dizziness, pain or unconsciousness. This is a life-threatening situation and medical attention should be pursued immediately.

Diagnosis & Treatment 

An aortic aneurysm is often detected during an imaging test, such as an ultrasound or CT scan, for a different medical condition. If you have risk factors or symptoms for an AAA see a vascular surgeon for diagnosis and treatment. A vascular surgeon is the only physician that can perform all the treatment options available. They may use an abdominal ultrasound, CT scan or MRI to determine the diagnosis.  The most important factor in determining the treatment plan is the size of the AAA.  

Watchful waiting can be employed when the AAA is less than 2 inches. The aneurysm is monitored with scheduled CT, MRI or ultrasound testing every 6-12 months. Lifestyle changes, such as quitting smoking, lowering blood pressure, and taking medication may also be required. The aneurysm will not go away on its own and it’s extremely important that the patient follows the follow-up schedule. 

Surgery may be required if the aneurysm is larger than 2 inches, is causing symptoms or is enlarging under observation.  

Open AAA repair surgery is over 90 percent successful for the long term. The surgeon will make an incision on your abdomen and replace the weakened part of your aorta with an aortic graft. The tube-like graft allows your blood to pass easily through.   

Endovascular stent graft is a minimally invasive surgery that usually requires small incisions in the groin area. The surgeon will use live x-ray pictures viewed on a screen to guide a fabric and metal tube (the endovascular stent graft also called endograft) to the site of the aneurysm. This procedure usually has a shorter recovery than an open AAA repair but it does require more frequent follow-up visits with imaging procedures.  

Each treatment option has its own benefits and risks. Prevea vascular surgeons work with each patient to determine the best treatment option for their situation.