This may cause life-threatening hemorrhage (uncontrolled bleeding). The larger the aneurysm becomes, the greater the risk of rupture. Sometimes, a tear can occur on the inside layer of the vessel resulting in blood filling in between the layers of the blood vessel wall and creating a dissection.
Because an aneurysm may continue to increase in size, along with progressive weakening of the artery wall, surgical intervention may be needed. Preventing rupture of an aneurysm is one of the goals of therapy. What causes an abdominal aortic aneurysm to form?An abdominal aortic aneurysm may be caused by multiple factors that result in the breaking down of the well-organized structural components (proteins) of the aortic wall that provide support and stabilize the wall. The exact cause is not fully known.
Atherosclerosis (a build-up of plaque, which is a deposit of fatty substances, cholesterol, cellular waste products, calcium and fibrin in the inner lining of an artery) is thought to play an important role in aneurysmal disease, including the risk factors associated with atherosclerosis. They include:
Other diseases that may cause an abdominal aneurysm include:
What are the symptoms of abdominal aortic aneurysms?
Aortic disease is often insidious. Most people with aortic aneurysms experience no symptoms, unless they are extremely large or an aortic dissection occurs. About three of every four abdominal aortic aneurysms are asymptomatic.
When present, symptoms may occur with different types of aneurysms may include, but are not limited to, the following: constant pain in abdomen, chest, back or groin area or a pulsatile mass in the abdomen. The pain associated with an abdominal aortic aneurysm may be located in the abdomen, chest, lower back, or groin area. The pain may be severe or dull. The occurrence of pain is often associated with the imminent (about to happen) rupture of the aneurysm. Acute, sudden onset of severe pain in the back and/or abdomen may represent rupture and is a life-threatening medical emergency. |
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Send your non-urgent questions regarding your aortic, heart, and vascular conditions via email directly to our expert team of doctors. --------------------- In the News Learn about transcatheter aortic valve replacement at Barnabas Health Dr. Craig Saunders is names "Top Doctor" by US News and World Report Dr. Mark Russo is awarded the Society of Thoracic Surgeons President's Award Drs. Bruce Brener and Cindy Sturt perform successfully marathon surgery ------------------- FAQ What is an enlarged aorta? An enlarged aorta is also known as an aortic aneurysm... What is transcatheter aortic valve implantation (TAVI)? TAVI also known as transcatheter aortic valve reimplantation (TAVR)... Can I exercise if I have an enlarged aorta, aortic aneurysm, or chronic dissection? Though some types of exercise should be avoided, exercise is generally encouraged... Who should be screened for an aortic aneurysm? Most people with aortic aneurysms experience no symptoms... |
How are aneurysms diagnosed?
For most people, their aortic condition is discovered incidentally while being tested for other reasons. An aneurysm may also be discovered by x-ray, computed tomography scan (CT scan), or magnetic resonance imaging (MRI) that is being done for other conditions. Since abdominal aneurysm may be present without symptoms, it is referred to as the "silent killer" because it may rupture before being diagnosed.
How is an abdominal aneurysm treated?
Treatment options for an aortic aneurysm may include one or more of the following:
- Controlling or modifying risk factors: such as quitting smoking, controlling blood sugar if diabetic, losing weight if overweight or obese and controlling dietary fat intake may help to slow the progression of the aneurysm
- Observation: routine ultrasound, CT, or MRI procedures to monitor the size and rate of growth of the aneurysm
- Medication: to control factors such as hyperlipidemia (elevated levels of fats in the blood) and/or high blood pressure
- Open Aneurysm Repair: the diseased area of the aorta if replaced with a fabric graft
- Stent graft or endograft: used to treat aneurysms of the descending and abdominal aneurysm; it is comprised of a layer of impermeable reinforcement material enclosed by a self-expanding metal support mesh and is placed across the aneurysm site
Open Aneurysm RepairAn incision is made in the abdomen to directly visualize the abdominal aorta and repair the aneurysm. A cylinder-like tube called a graft may be used to repair the aneurysm. Grafts are made of various materials such as Dacron (textile polyester synthetic graft) or polytetrafluoroethylene (PTFE, non-textile synthetic graft). This graft is sewn to the aorta, connecting one end of the aorta at the site of the aneurysm to the other end. The open repair is considered the surgical standard for an abdominal aortic aneurysm repair.
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Endovascular Aneurysm Repair (EVAR)
EVAR is a procedure that requires only small incisions in the groin, along with the use of x-ray guidance and specially-designed instruments, to repair the aneurysm by inserting a tube, called a stent-graft, inside the aorta. In this minimally invasive procedure, the stent graft (comprised of a layer of impermeable reinforcement material enclosed by a self-expanding metal support mesh) is placed across the aneurysm site. To achieve stent graft placement, the surgeon inserts a catheter through the femoral artery in the groin. The stent graft is then delivered through the catheter in a collapsed state and deployed at the site of the aneurysm. The device replaces and reinforces the diseased aortic wall, ensuring continuity of blood flow. The potential benefits of the procedure include greatly reduced risk, a shorter hospital stay, and a more rapid recovery. Not all aortic aneurysms can be repaired with EVAR.
Specific treatment will be determined by your physician based on: age, overall health and medical history; size, location, and extent of the disease; signs and symptoms; tolerance of specific medications, procedures or therapies; expectations for the course of the disease; and preference.
Specific treatment will be determined by your physician based on: age, overall health and medical history; size, location, and extent of the disease; signs and symptoms; tolerance of specific medications, procedures or therapies; expectations for the course of the disease; and preference.
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Animation of an Endovascular
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Patient Experience
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