Abdominal Aortic Aneurysm
An abdominal aortic aneurysm, known as an AAA, is a weakening in the wall area in the aorta, the main artery that carries blood from the heart to the rest of the body. As blood flows through the aorta, the weak area bulges and can rupture.
Most often, an AAA presents no symptoms and is referred to as a silent killer. But when symptoms occur, they may include:
- Abdominal pain, which may be constant or intermittent.
- Lower back pain that may extend to the buttocks, groin or legs.
- A feeling of a heartbeat, or pulse in the abdomen.
Once an aneurysm bursts, symptoms may include:
- Severe back or abdominal pain that begins suddenly
- Dry mouth and skin with excessive thirst
- Nausea and vomiting
- Signs of shock such as sudden weakness, dizziness, fainting, shaking, sweating and rapid heartbeat
Anyone experiencing symptoms associated with a burst aneurysm should seek immediate medical care.
In some cases, an AAA can be diagnosed when a physician feels the aneurysm as a soft mass in the abdomen – near the belly button – that pulses with each heartbeat. Several tests may be used to diagnose an AAA but the most common are an ultrasound or CT (computerized tomography) scan. Ultrasound screening involves a device about the size of a computer mouse being passed over the abdomen while sound waves create images that can detect the AAA. A CT scan compiles a series of X-ray images and creates cross-sectional pictures of the area being screened.
Patients have three treatment options for an AAA:
Watchful waiting – small AAA's, less than 5 centimeters or about 2 inches, that are not growing quickly or causing symptoms may just be monitored with ultrasound screenings at regular intervals.
Interventional repair – with this minimally invasive technique Holy Name Medical Center's Interventional Radiologists use X-ray imaging to guide a catheter through the groin and femoral artery into the aortic. A stent graft is then advanced through the catheter and into the artery to reline the weakened aorta. This method of treatment eliminates the need for a large abdominal incision and is now the standard of care for treating most AAAs.
Long held as the only treatment for an AAA, open surgery requires an incision from just below the breastbone to the top of the pubic bone. Physicians then clamp off the aorta and place a plastic graft into the weakened area to protect the artery wall. General anesthesia is used and patients are hospitalized for several days.
After an interventional repair, patients typically spend one night in the hospital and most return to normal activity within two weeks of their procedure.
Surgery repairs usually require the patient to spend several days in the hospital and then a six-to-eight week interval before all daily activities can be resumed.
Benefits of Interventional Treatment
- No abdominal surgical incision or sutures
- Faster recovery with less time in the hospita
- Some cases require no general anesthesia
- Less pain and reduced complications