Abdominal Aortic Aneurysms
An aneurysm is a bulge in or an enlargement of an artery's wall resulting from the weakening of the arterial tissue. Arteries are blood vessels that transport oxygen-rich blood from the heart to various organs. Most aneurysms occur within the aorta, the primary artery responsible for carrying blood away from the heart and into the abdomen, pelvis and legs.
What Is Abdominal Aortic Aneurysm?
An abdominal aortic aneurysm (AAA) is the ballooning or swelling of an aorta in the abdomen. The abdominal part of the aorta runs behind the stomach area and is the most common place for an aneurysm.
Males over age 65 who have one or more risk factors are most at risk for abdominal aortic aneurysm. Risk factors can be family history, behaviors or lifestyle that can increase the chance of developing AAA, such as:
- A history of smoking. Smoking accounts for about 75% of all abdominal aortic aneurysms.
- Genetics—for example, if a parent or sibling had AAA
- Older age, especially age 65 years or older
- Race - Caucasians are at higher risk for developing AAA
- Having other aneurysms, like thoracic aortic aneurysm (similar to AAA but in the chest instead of the abdomen)
- High blood pressure
- Heart disease or vascular disease (problems with blood vessels)
The larger the aneurysm, the more likely it is to break open or tear. Aortic aneurysms can either:
- Dissect: When the force of blood pumping through the aorta splits the layers of its wall, causing the blood to leak between them.
- Rupture: When the aneurysm bursts completely, which causes internal bleeding
Dissections and ruptures are the leading causes of death from aortic aneurysms.
What Causes an Aneurysm in the Aorta?
The exact cause of an abdominal aortic aneurysm is not always clear. However, factors such as atherosclerosis (hardened arteries), infection or injury can cause AAA.
AAAs that have not ruptured are picked up or diagnosed during ultrasounds or CT scans done for other reasons, or when the physician feels the patient's stomach and finds the following during an examination:
- A lump (mass) in the abdomen
- Pulsating sensation in the abdomen
The following tests help physicians diagnose an abdominal aortic aneurysm:
- Abdominal ultrasound
- Chest x-ray or abdominal x-ray
- Computerized tomography (CT) scan of the abdomen to confirm the size and location of the aneurysm
- CT angiogram (CTA) to help with surgical planning
AAAs are classified according to their size and the rate at which they are growing. These two factors give physicians an idea of how the aneurysm affects the patient's health with this condition.
- Small AAA (3 cm to 4.4 cm across): These are slow-growing aneurysms with a much lower risk of rupture. Regular ultrasound scans are recommended to monitor their growth.
- Medium AAA (4.5 cm to 5.4 cm): These types of aneurysms require ultrasound scans more frequently to check if they are getting bigger.
- Large AAA (5.5 cm or larger): These AAAs are much more likely to rupture, leading to life-threatening complications. These types of AAAs need to be treated with surgery or stenting, especially if they are causing symptoms or leaking blood.
What Does an Aneurysm Feel Like?
Abdominal aortic aneurysm treatments depend on size and exact location.
The two types of surgery are:
- Open repair: The more invasive form of surgery for aneurysms, more common for those that are very large or have already ruptured. This procedure involves making a large cut in the abdomen to replace the damaged areas of the aorta with a graft made of artificial material. This type of surgery has a longer recovery time.
- Endovascular stent grafting: A less invasive form of surgery that can be done without making a large cut in the abdomen, making recovery time faster than an open repair surgery. It uses a graft attached to a stent to stabilize the weakened walls of the aorta.
If you think you or someone you know has abdominal aortic aneurysm symptoms, call 911 right away.
Find a Vascular Surgeon in San Antonio
Whether you need preventive or emergency vascular care, we are here to help. To schedule an appointment with a vascular surgeon at the Vascular Institute of San Antonio, connect with our network of providers here or call 210-962-5709. Our vascular care addresses various conditions, including peripheral artery disease, carotid artery disease, dialysis access, abdominal aortic aneurysms and venous disease.