Introduction
The Aorta is the main blood vessel running through the chest and abdomen to supply blood to most of the body. An aneurysm is a dilatation or swelling of an artery that can weaken the wall and is at risk of rupturing. Abdominal aortic aneurysm (AAA) are the commonest site for them to occur although they may develop in any blood vessel.
Aortic aneurysms are quite common and occur in up to 6% of men over the age of 80. AAA are more common as we get older and although more common in males they do occur in females as well.
The main danger of a AAA is the risk of rupture. This is a life-threatening event with a high risk of death even with emergency surgery. The risk is related to there size. AAA less than 5.5 cm in diameter rarely cause problems and it is recommended to treat them once they are over this size. The length of a AAA does not affect the risk of rupture.
Causes
In many cases the cause of a AAA is unclear.
Known risk factors include:
- A family history of aneurysms.
- Older age.
- Smoking.
- Heart disease.
- High blood pressure.
- Genetic connective tissue disorders.
Symptoms
Most patients with aortic aneurysms do not have any symptoms unless they rupture. Ultrasound or CT scans performed for other reasons are the commonest way that AAA are identified.
Known risk factors as above should prompt an ultrasound scan to exclude a AAA. Aneurysm diagnosis in other blood vessels should also prompt screening scans of the Aorta.
Tests
Ultrasound (USS) is a very good screening test for abdominal aortic aneurysms. USS is also used to monitor smaller aneurysms until they reach a size that requires treatment. A CT scan is used to confirm USS findings and to plan treatment.
In patient with a strong family history of AAA an ultrasound scan is recommended.
Diagnosis
Most AAA diagnoses occur from USS or CT imaging performed to investigate other issues. Both tests are accurate and are used for monitoring and planning treatment. Unfortunately, blood tests will not identify the presence of an aneurysm.
Treatment
There are a number of options to manage AAA once they are diagnosed. Surveillance imaging is recommended for patients with small < 5 cm AAA. Aneurysm that are over 5.5 cm should be treated.
Options for Aneurysm treatment include:
- Endovascular (or Keyhole) Stenting.
- Open abdominal surgery.
Related Information
Thoracic Aortic Aneurysms
Aortic Aneurysm Open Repair
Aortic Aneurysm Stenting
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