Abdominal Aortic Aneurysms (AAA)

  • Abdominal aortic aneurysm

An aneurysm is an abnormal dilatation of a blood vessel. The commonest site to develop an aneurysm is the aorta, which is at the back of the abdomen just below the kidneys. An aneurysm in this area is called an abdominal aortic aneurysm and often referred to as an AAA.

What is Abdominal Aortic Aneurysms (AAA)?

AAAs gradually grow at a rate of around 1 to 5 mm per year.  The bigger they get, the more likely they are to burst and a ruptured AAA is a common cause of sudden death.   Males are 8 times more likely to be affected than females, and 1 in 20 men over the age of 65 have an AAA. Females with an aneurysm are more prone to rupture than their male counterparts, however. 

 

The risk of rupture rises sharply once the aneurysm diameter exceeds 6cm, therefore repair is advised for aneurysms over 5.5cm in all but very unfit patients. Most AAAs are asymptomatic until they burst. Many AAAs are detected by accident during tests for other problems (ultrasound is particularly accurate) but screening programmes can help reduce deaths due to aneurysm rupture. 

 

 

What part of the body does it affect?

Unsurprisingly, Abdominal Aortic Aneurysms are found in the abdomen. 

What are the treatment options?

Is the condition preventable? If so, how?

The main risk factors for developing an aortic aneurysm are age, being male and your family history, which obviously you can't do a lot about. Smoking is also a huge risk factor, however, so stopping will dramatically improve your chances of not developing an AAA. 

What should I do next?

There are two ways to repair an abdominal aortic aneurysm for most patients: open repair and endovascular (key-hole) repair using a stent-graft.

 

Open aneurysm repair

Open repair comprises replacement of the aneurysmal aorta with an artificial graft stitched into place just below the renal arteries.  This is major abdominal surgery with significant risks involved.  The risks depend on the extent of the aneurysm, and the age and fitness of the patient.  Despite these concerns, the long term outlook after open repair is good and open aortic reconstruction is a very durable procedure that lasts for years without further problems or intervention.

 

Endovascular aneurysm repair (EVAR)

Endovascular aneurysm repair allows a stent-graft to be placed inside the aneurysm via the femoral artery, then expanded and fixed in position under Xray guidance.  The whole procedure can be performed via small groin incisions (keyhole surgery).  Recovery is much quicker than for open repair and less fit patients can be treated.  The risk of severe complications is also much lower.  

 

For more details see the relevant pages in the treatment area of this website or contact the London Vascular Clinic to discuss your questions. 

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