Abdominal Aortic Aneurysm Treatment Program
Abdominal Aortic Aneursyms (AAA) have a modern approach to their management through non-surgical and surgical treatments. When surgery is necessary, intervention through bilateral groin regions allows for deployment of stent grafts with minimal recovery time.
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The aorta is a large artery that carries blood from the heart, through the abdomen to the legs. An abdominal aortic aneurysm is a bulging or ballooning in a weakened wall of the lower part of the aorta. Similar to a balloon, as an aneurysm continues to enlarge, the walls of the aorta stretch making them much thinner. The aortic aneurysm eventually reaches a point where it loses its ability to stretch any further. At this point, without any treatment it may rupture, causing potentially fatal bleeding.
Why do I have an Abdominal Aortic Aneurysm?
There are many factors that can put you at risk of developing an abdominal aortic aneurysm. Some may be hereditary and others may be related to your lifestyle:
- Hypertension (high blood pressure)
- Age greater than 65 years
- Male gender
- Inherited connective tissue disorders: Marfan syndrome, Ehlers-Danlos syndrome, collagen vascular diseases
- COPD (chronic obstructive pulmonary disease)
- Coronary artery disease or heart disease
- Those with a first degree relative with an abdominal aortic aneurysm are at a greater risk
- Infection or inflammation
How is it diagnosed?
There may be no symptoms until the abdominal aortic aneurysm has enlarged significantly, is leaking or has ruptured. In this instance, symptoms that are reported would include abdominal, lower back, groin or chest pain.
A physician may note a pulsating mass under the skin of your abdomen, or hear abnormal blood flow sounds when listening with a stethoscope.
Tests that can confirm diagnosis:
- Abdominal ultrasound
- Computed tomography scan (CT scan)
- Magnetic resonance imaging (MRI)
What are my treatment options for an abdominal aortic aneurysm?
If your aneurysm has been discovered early and is still small (less than 5 centimeters), surgery may not yet be necessary. In this case, your vascular surgeon will closely monitor the growth of your aneurysm every 6-12 months by obtaining CT scans. Additionally, it is important to quit smoking and control your risk factors, such as keeping your blood pressure under control with medication.
Once your aneurysm has reached 5 centimeters, the risk of rupture is much higher and surgery is recommended. Your vascular surgeon will decide what the best options are for you at that time and discuss complications and risks. There are two choices for treatment:
- Traditional Open Repair of AAA: A large surgical incision is made into your abdomen to directly visualize your aortic aneurysm. The aneurysm is opened and a cylinder-like tube known as a graft is sewn inside to repair it. Ultimately, the weakened area of the aorta is relined with a sleeve of material to strengthen it and prevent rupture of the aneurysm. Hospital stay with this procedure is about 5 days, with full recovery at 6 weeks.
- Endovascular Repair of AAA: A less invasive approach than traditional surgery, this repair involves only a small incision in the groin. Endovascular means that the procedure uses long thin tubes inside your body called catheters. Under guidance of an x-ray, a small catheter is placed through the groin incision and used to pass a cylinder-like tube called a graft up into the aneurysm. This graft is placed so that the ends fit neatly into the non-diseased portion of the artery at the opposite ends of the aneurysm. This is relining the weakened area of the aorta with a strong sleeve of material, thus preventing rupture of the aneurysm. Hospital stay for this procedure is about 1 day, with full recovery in about 1 week.
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