Abdominal Aortic Aneurysm (AAA)

The aorta is the largest artery in your body, running from your heart through the middle of your chest and abdominal area. An abdominal aortic aneurysm is a weakened area of the aorta in the abdomen that bulges or expands.

The greatest concern with an abdominal aneurysm is that it may rupture or burst. The larger the aneurysm is, the greater the risk of it rupturing. Aneurysms that rupture can cause severe internal bleeding, which can be fatal. Fortunately, this condition can be successfully treated and cured when diagnosed prior to rupture. Caring for an abdominal aortic aneurysm is one of many offerings for vascular care at Ohio State.

Causes

While the exact cause is unclear, an abdominal aortic aneurysm may be caused by multiple factors that damage the aortic wall: 

• Atherosclerosis (hardening of the arteries)
• Infection
• Injury to the aorta
• Connective tissues disorders, including Marfan syndrome

Other risk factors that contribute to abdominal aortic aneurysm include:

• Family history of aneurysms
• Elevated fats in the blood
• Being male
• Diabetes
• High blood pressure
• Over age 45 for women or over 55 for men
• Smoking

Many of these risk factors can be reduced or eliminated by changing your lifestyle. Men older than 60 who have ever smoked should have a one-time screening for abdominal aortic aneurysm with a simple ultrasound test.

Screening

The Society of Vascular Surgery recommends a one-time ultrasound screening for men over age 65 or over age 55 if you have a family history of aortic aneurysms. Women older than 65 who have smoked or have a family history of aneurysms should also be screened.

Abdominal Aortic Aneurysm symptoms

Unfortunately, most people don't experience symptoms with an abdominal aortic aneurysm until it ruptures or bursts. However, the following symptoms can indicate that an aneurysm is present:

• Blood in urine
• Mass in the abdomen
• Pulsating in your abdomen (similar to a heartbeat)
• Sores, discoloration or pain on your feet (due to material shed from an aneurysm)
• Stiff or rigid abdomen
• Sudden, intense pain in your abdomen or lower back (may signify an aneurysm that is about to rupture; seek immediate medical care)

A ruptured aneurysm is very dangerous and requires emergency medical care. Symptoms of a ruptured aneurysm include:

• Dizziness or lightheadedness
• Drop in blood pressure
• Increased heart rate
• Pain

Diagnosis

When an abdominal aortic aneurysm is detected, it is usually incidental during an examination for another condition. Tests to confirm the presence of an abdominal aortic aneurysm include:

• Abdominal ultrasound – A painless, noninvasive diagnostic test used to detect an abdominal aortic aneurysm
• Echocardiogram – A test that looks at your heart to determine function, evaluate heart valves and measure the thoracic aorta
• MRI (magnetic resonance imaging) – A noninvasive, sophisticated imaging procedure that uses large magnets and a computer to produce detailed images of organs and structures inside the body
• CT scan (computed tomography scan) – An imaging procedure that uses X-rays and computer technology to produce cross-sectional, detailed images of the body, including bones, muscles, fat and organs

Abdominal Aortic Aneurysm treatment

Treatment of an abdominal aortic aneurysm depends on its size and the symptoms an individual may be experiencing. The goal is to prevent the aneurysm from ever rupturing. Medication to control high blood pressure and to lower cholesterol may be prescribed. Surgery may also be indicated.

There are generally two types of aneurysm repair surgeries:

• Endovascular repair makes use of a catheter that guides a stent graft through small incisions in the groin. The graft is inserted into the aneurysm and seals the aneurysm from within.
• Open surgical repair of the abdominal aortic aneurysm may be recommended if the aneurysm anatomy does not allow for endovascular repair. In this procedure, the damaged area is removed and replaced with a graft.

A ruptured aneurysm is a very dangerous condition. Although it is possible to repair a ruptured aneurysm surgically, it is important to identify and treat aneurysms before a rupture occurs.