LifeBridge Health > Medical Services > Vascular Institute > Abdominal Aortic Aneurysm

Abdominal Aortic Aneurysm

Abdominal aortic aneurysms (AAA) are caused by progressive weakening of the aortic wall that causes a “ballooning” of the vessel. The aneurysm will grow larger and may rupture if it is not diagnosed or treated. Aneurysms occur most often in the aorta, the main artery of the chest and abdomen and the largest artery in the body. The aorta carries blood flow from the heart to all parts of the body including the vital organs, legs and feet.

There are approximately 15,000 deaths each year related to the rupture of an aneurysm. Ruptured aneurysms are the 10th leading cause of death in men over the age of 50 in the United States, however women are also at risk. A ruptured aneurysm that requires emergency treatment can lead to severe pain, internal bleeding, a sudden drop in blood pressure, and if not treated, death. A ruptured aneurysm is an emergency and procedures must take place immediately to save one’s life and to avoid serious complications.

What causes an AAA?

Aneurysms are caused by a weakening of the wall of the aorta, allowing it to expand like a balloon. Inflammation that is associated with atherosclerosis (hardening of the arteries) helps to accelerate this process, even in young people. Some of the body’s naturally occurring enzymes may also cause the breakdown of collagen and elastin in the wall of the aorta. An excess of these enzymes or conditions that activate the enzymes may cause the formation of an aneurysm, or lead to its sudden growth. In rare cases, an aneurysm may be caused by infection.

Aneurysms that have been discovered prior to rupture need to be measured, closely monitored and evaluated for treatment. Small aneurysms can often be left untreated, yet observed periodically to check for growth.

Symptoms

In most cases there are no symptoms associated with AAA.  Some aneurysms are only discovered upon rupture.  Prior to rupture, aneurysms may be found during a routine physical exam or during diagnostic tests such as ultrasound, X-rays or MRIs, which have been ordered to evaluate some other health problem.

Risk Factors

The exact cause of an abdominal aortic aneurysm (AAA) is unknown.  However, the most common risk factors for AAA include:

  • Over 60 years of age
  • Gender:  AAA is five times more likely in men than in women.
  • Smoking:  Smokers are eight times more likely to be affected.
  • History of heart disease or peripheral arterial disease (PAD)
  • Hyperlipidemia (elevated levels of fat in the blood)
  • High blood pressure (hypertension)
  • Family history of AAA

Diagnosis

Most abdominal aortic aneurysms (AAAs) are diagnosed using an ultrasound scan or with a CT scan, though they can also be diagnosed during a physical exam. The scans are simple, non-invasive exams conducted on an outpatient basis. These exams measure the diameter of AAAs—a key element in determining the best treatment. Many times, AAAs are discovered during imaging tests, such as X-rays or MRIs, that are being performed for other reasons.

The LifeBridge Health Vascular Institute uses ultrasound diagnostic imaging and other non-invasive testing methods to provide objective and reliable assessments for many types of vascular problems, including AAAs.

Treatment

The risk of a rupture is increased if an abdominal aneurysm is greater than five centimeters (about the size of a lemon) or if the aneurysm is rapidly increasing in diameter—greater than one centimeter per year. Elective surgical repair of the aorta is the only definitive cure. However, risk of rupture must be weighed against the risks associated with surgery. Surgical procedures have a high success rate, with more than 95 percent of patients making a full recovery.


For more information about the treatment of abdominal aortic aneurysms, call LifeBridge Health at 410-601-WELL (9355).