How Did I Get an 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 and 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 Are Aneurysms 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)
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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. 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.
Where Is the Procedure Performed and Who Performs This Procedure?
This aortic aneurysm treatment procedure is performed in the hospital surgical suite by a vascular surgeon.
How Do I Find out If I Am a Candidate for This Procedure?
To find out if you are a candidate for this procedure, please call the Vascular Health Clinics at 989.254.6427.
How Can I Prevent the Formation of an Aortic Aneurysm?
There are two considerations in prevention regarding abdominal aortic aneurysms:
- Prevention of aortic aneurysm development
- Prevention of aortic aneurysm rupture
Aortic aneurysms that are due to inherited tissue disorders (Marfan or Ehlers-Danlos syndromes or other collagen vascular diseases) cannot be prevented. Also, age, family history, and the gender predilection toward males are all givens. Risks for aneurysms involving infection, inflammation, and trauma are unpredictable. All of this fall into the category of preventing rupture.
The risk factors of aneurysms that can be prevented are:
- Hypertension (high blood pressure)
- Smoking and its progression to COPD and coronary artery, heart, and cardiovascular disease (CVD)
Treatment of hypertension via lifestyle changes, diet, and exercise can be augmented by the use of antihypertensive medication. This is crucial in those already diagnosed with an aortic aneurysm, due to the hypertensive risk of its dissection or rupture.
Smoking is included in the change in lifestyle, and there are medications that can help when conventional non-pharmaceutical approaches fail. Smoking’s complications of COPD and CVD secondarily raise the risk of dissection or rupture of an existing aneurysm. Therefore, smoking cessation will reduce the secondary risks that arise from the complications to which smoking contributes.
Dietary adjustments are also part of the change in lifestyle, since hypertension and CVD can be impacted negatively or positively by diet. Counseling with a certified dietitian/nutritionist will assure reliable information upon which a patient can construct an appropriate diet.