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An abdominal aortic aneurysm is when the large blood vessel that supplies blood to the abdomen, pelvis, and legs becomes abnormally large or balloons outward.
Aneurysm - aortic; AAA
The exact cause is unknown, but risk factors for developing an aortic aneurysm include:
An abdominal aortic aneurysm can develop in anyone, but is most often seen in males over 60 who have one or more risk factors. The larger the aneurysm, the more likely it is to rupture and break open.
Aneurysms develop slowly over many years and often have no symptoms. If an aneurysm expands rapidly, tears open (ruptured aneurysm), or blood leaks along the wall of the vessel (aortic dissection), symptoms may develop suddenly.
The symptoms of rupture include:
Your doctor will examine your abdomen. The exam also will include an evaluation of pulses and sensation in your legs. The doctor may find:
You may have an abdominal aortic aneurysm that is not causing any symptoms or problems. Your doctor may have found out about this problem from special tests called ultrasound of the abdomen or CT scan of the abdomen.
Either of these tests may be done when you're having symptoms.
If you have bleeding inside your body from an aortic aneurysm, you will have open abdominal aortic aneurysm repair.
If the aneurysm is small and there are no symptoms:
Surgery is usually recommended for patients who have aneurysms bigger than 2 inches or 5.5 cm across and aneurysms that are growing quickly. The goal is to perform surgery before complications or symptoms develop.
There are two approaches to surgery:
The outcome is usually good if an experienced surgeon repairs the aneurysm before it ruptures. However, less than 40% of patients survive a ruptured abdominal aneurysm.
When an abdominal aortic aneurysm ruptures, it is a true medical emergency. Aortic dissection occurs when the innermost lining of the artery tears and blood leaks into the wall of the artery. This most commonly occurs in the aorta within the chest.
Go to the emergency room or call 911 if you have pain in your belly or back that does not go away or is very bad.
To reduce the risk of developing aneurysms:
Men over age 65 who have ever smoked should have a screening ultrasound performed once.
Gloviczki P, Ricotta JJ II. Aneurysmal vascular disease. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 65.
Greenhalgh RM, Powell JT. Endovascular repair of abdominal aortic aneurysm. N Engl J Med. 2008;358:494-501.
Lederle FA, Kane RL, MacDonald R, Wilt TJ. Systematic review: repair of unruptured abdominal aortic aneurysm. Ann Intern Med. 2007;146:735-741.
Isselbacher EM. Diseases of the aorta. In: Libby P, Bonow RO, mann DL, Zipes DP. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 56.