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Abdominal Aortic Aneurysm

What is an Abdominal Aortic Aneurysm?

An aneurysm is a localized dilation or bulge in a blood vessel. Abdominal and thoracic aneurysms occur when the aorta dilates more than 150% of its normal diameter at a particular point. The larger the bulge becomes, the greater the risk that the aorta will burst, causing an internal hemorrhage. Congenital abnormalities, infections, atherosclerosis or hypertension can lead to a weakening of the blood vessel wall, allowing an aneurysm to develop. Lifestyle habits such as smoking and a poor diet can also be contributing factors. Many times physical exam results will be normal and patients may be asymptomatic; however, symptoms can include back, chest or abdominal pain. Other symptoms include hoarseness, wheezing and difficulty swallowing. Patients typically experience hypotension (low blood pressure), tachycardia (fast heart beat) and shock if the aneurysm ruptures. Almost six in 100,000 people will develop and aortic aneurysm. Men are two to four times more likely to be affected than women and the average age at the time of diagnosis is 60-70 years of age.Blood work, contrast-enhanced CT scans, magnetic resonance imaging (MRI), contrast angiography, chest radiography, transesophageal echocardiography, or an electrocardiogram may be performed to determine a diagnosis.If an aneurysm is detected, it is typically treated surgically with a synthetic portion of blood vessel patching the area where the aneurysm was. Small aneurysms may be monitored for a period of time to see if they enlarge.

Treatment Options

Endovascular Repair

Endovascular repair was developed after the more invasive open aneurysm repair. In this procedure, your vascular surgeon inserts catheters into an artery in your groin and guides them to the blockage. The surgeon will watch the procedure on a video screen to assure proper placement of the stent. Once in place, the stent will allow blood to flow through, keep the artery open and prevent additional pressure on the damaged artery walls, thus preventing the aneurysm from rupturing.With this procedure, patients have a shorter hospital stay and recover much more quickly than with the open aneurysm repair. Post-operatively, it’s important for patients to have regular check-ups to make sure that the stent is in the proper position and that it is functioning correctly.

Open Aneurysm Repair

The open aneurysm repair requires your surgeon to make an incision in your chest or abdomen, where a graft will be inserted into the aorta at the aneurysm site. The graft is a fabric tube that allows blood to flow through, but protects the damaged arterial walls from pressure.

Angiography

If your physician suspects an obstruction in an artery, you may need to have an angiography, which enables the physician to exam the blood vessels through an X-ray examination. Prior to the test, patients are typically given a mild sedative and a local anesthetic is applied where the catheter will be inserted.In conjunction with the X-ray, a contrast dye is injected through a catheter that is inserted into an artery in your arm or groin. The dye is then visible on the X-ray pictures, called angiograms, which allow the physician to see the blood flow. The angiography will show how many arteries are blocked and the location of each blockage, as well as how severe each blockage is.