Abdominal Aortic Aneurysms (AAA)
What is an abdominal aortic aneurysm (AAA)?
How common are abdominal aortic aneurysms?
What are the symptoms?
What causes an abdominal aortic aneurysm?
What tests will I need?
How is an abdominal aortic aneurysm treated?
What is an abdominal aortic aneurysm (AAA)?

How common are abdominal aortic aneurysms?
Approximately 200,000 people in the United States are diagnosed each year with an AAA. About ten percent of these meet criteria where the threat of death from rupture outweighs the risk of surgery. A ruptured AAA has a five percent survival rate while an electively repaired aneurysm has a 95% survival rate. This is because when diagnosed early before it causes symptoms, an AAA can be treated, or even cured, with highly effective and safe treatments.What are the symptoms?
Most aortic aneurysms are diagnosed incidentally. In other words, when a patient is being evaluated for something else, an aneurysm is either identified on physical exam or an x-ray such as an ultrasound or CT scan. Therefore, most people with AAAs don’t have or feel any “symptoms”. If one were to develop symptoms, one may experience one or more of the following:- A pulsatile feeling in your abdomen, commonly between the ribs and the belly button; similar to a heartbeat.
- Severe, sudden pain in your abdomen or lower back with associated sweating and general weakness could be quite concerning for an aneurysm that may be on the brink of rupture.
- On rare occasions, your feet may develop pain, discoloration, or sores on the toes or feet because of material shed from the aneurysm (embolization).
What causes an abdominal aortic aneurysm?
Multiple theories abound as to the cause of aneurysm formation. Some researchers believe that the aneurysm may be caused by inflammation in the aorta, which may cause its wall to weaken or break down. This inflammation can be associated with atherosclerosis (also called hardening of the arteries) or risk factors that contribute to atherosclerosis, such as high blood pressure (hypertension), hereditary factors and smoking. Atherosclerosis causes plaque formation which may lead to “hardening” or “stiffening” of the walls of the aorta, thus causing it to weaken and therefore expand. It is unclear why in some people the aorta expands and causes an aneurysm while in others the aorta narrows because of the plaque buildup, causing what is known as occlusive disease. In addition to atherosclerosis, other factors that can increase your risk of AAA include:- Being a man older than 60 years.
- Having a first degree relative, such as a parent or sibling is associated with a 15-20% chance of having an aneurysm. Thus why it is also important that if a patient has an aneurysm that they need to notify all their first degree relatives to consider being screened for an aneurysm as well (usually through an abdominal ultrasound).
- Having high blood pressure.
- Having an aneurysm elsewhere in the body, such as the legs or carotid arteries.
- Smoking.
What tests will I need?
As mentioned earlier, abdominal aortic aneurysms that are not causing symptoms are most often found when a physician is performing an imaging test for another condition. Sometimes your physician may feel a large pulsing mass in your abdomen on a routine physical examination. If an AAA is suspected, an imaging test should be performed to confirm the suspicion. The most common tests are an abdominal ultrasound, a computed tomography scan of the abdomen (CT scan) or a magnetic resonance imaging (MRI) of the abdomen.How is an abdominal aortic aneurysm treated?

Endovascular stent graft
Instead of open aneurysm repair, your vascular surgeon may consider a newer procedure called an endovascular stent graft. Endovascular means that the treatment is performed inside your artery using long, thin tubes called catheters that are threaded through your blood vessels. This procedure is less invasive, meaning that your surgeon will usually need to make only small incisions in your groin area through which to thread the catheters. During the procedure, your surgeon will use live x-ray pictures viewed on a video screen to guide a fabric and metal tube, called an endovascular stent graft (or endograft), to the site of the aneurysm. Like the graft in open surgery, the endovascular stent graft also strengthens the aorta. Your recovery time for endovascular stent grafting is usually shorter than for the open surgery, and your hospital stay may be reduced to 2 to 3 days. However, this procedure requires more frequent follow-up visits with imaging procedures; usually CT scans, after endograft placement to be sure the graft continues to function properly. Also, the endograft is more likely to require periodic maintenance procedures than does the open procedure. In addition, your aneurysm may not have the shape that is suitable for this procedure, since not all patients are candidates for endovascular repair because of the extent of the aneurysm, or its relationship to the renal (kidney) arteries, or