SpiersMattison897

Abdominal Aortic Aneurysm An abdominal aortic aneurysm is a dilation (ballooning) of section of the aorta that is located in the abdomen. An abdominal aortic aneurysm quite often triggers no symptoms except when it ruptures (bursts). A ruptured abdominal aortic aneurysm is usually fatal. An abdominal aortic aneurysm less than 50 mm wide carries a below average probability of rupture. An operation to take care of the aneurysm may be proposed if it is larger sized than 50 mm, as above this size the danger of rupture grows. Individuals 65 years old and over are to be supplied a program scan to screen for abdominal aortic aneurysm.

What is the aorta? The aorta is the major artery (blood vessel) in the body. It carries blood from the heart and descends through the chest and the abdomen. Many arteries come off the aorta to supply blood to all parts of the body. At about the level of the pelvis the aorta divides into two arteries, one going to each leg.

What is an aneurysm and an abdominal aortic aneurysm? An aneurysm is where a part of an artery widens (balloons out). The wall of an aneurysm is weaker than a normal artery wall. The force of the blood inside of the artery leads to the weaker section of wall to balloon.

 

Aneurysms could occur in any existing artery, but they most typically take place in the aorta. Most aortic aneurysms occur in the segment of the aorta that moves through the abdomen. These are identified as abdominal aortic aneurysms (AAAs). Sometimes they occur in the segment going through the chest. These are known as thoracic aortic aneurysms.

The regular dimension of the aorta in the abdomen is around 20 mm. An abdominal aortic aneurysm is said to be present if a section of the aorta within the abdomen is 30 mm or more in diameter.

The rest of this leaflet is only about AAAs.

AAAs range in size. As a rule, as soon as you develop an AAA, it leads progressively to get larger sized. The speed at which it obtains larger varies from person to person. However, on average, an AAA tends to get larger by around 10% per year.

What causes an abdominal aortic aneurysm? In most cases The actual factor why an aneurysm figures in the aorta in most cases is not well-defined. Most scenarios take place in aged people. An AAA is rare in people under the age of 60. For that reason, getting old has a main factor to play.

The wall of the aorta typically has levels of sleek muscle, and layers built from tissues named elastin and collagen. Elastin and collagen are strong supporting tissues. What seems to happen is that a part of the aorta loses its usual toughness and elasticity in some people as they grow older. Researching advises that this is because of to changes in the elastin, collagen and smooth muscle tissues. There seem to be complicated biochemical procedures that trigger these modifications. Some people are more prone than others to these changes.

Your genetic make-up performs a part, as you have a considerably higher chance of raising an AAA if one of your parents has, or had, one.

Atheroma may as well play a part. Atheroma is a fatty material that deposits within the inside lining of arteries. Atheroma is sometimes named furring of the arteries. Most AAAs are lined with some atheroma. Any individual can develop atheroma, but it develops more commonly with increasing age. Particular risk variables also enhance the chance of atheroma growing. They include: tobacco use, high blood pressure, diabetes, raised cholesterol level, taking little exercise, and obesity. These are the same risk factors that enhance the chance of atheroma forming in the heart (coronary) arteries, which can cause angina and heart attacks. In a minority of cases Rare triggers of AAAs include injury or infection of the aorta. Also, certain uncommon genetic factors can affect the artery structure. In these uncommon situations an aneurysm may develop at a rather young age.

How ordinary are abdominal aortic aneurysms? About 6 in 100 men and about 2 in 100 women over the age of 65 have an AAA. It gets more common with increasing age. Though, most people with an AAA are not careful that they have one. An AAA is rare in people below the age of 60.

What is the concern about an abdominal aortic aneurysm? The main concern is that the aneurysm could rupture (burst). The wall of the aneurysm is less strong than a natural artery wall and may not be able to stand up to the tension of blood internally. If it ruptures then severe internal bleeding occurs which is often fatal. Of course, most AAAs do not rupture - only a certain proportion (see below).

What are the signs of an abdominal aortic aneurysm? Usually there are no warnings. At the time of diagnosis, 7 in 10 people with an AAA will not have had any symptoms due to the aneurysm. The ballooning of the aneurysm does not result in any symptoms unless of course it gets large sufficient to put force on nearby structures. If symptoms do appear, they are likely to be mild abdominal or back discomfort. There are many causes of mild abdominal and back pain. As a result, the diagnosis could be delayed unless the aneurysm is large enough to be sensed by a doctor when he or she examines your abdomen.

Occasionally small blood clots form on the inside lining of an AAA. These may break off and be transported down the aorta and obstruct a smaller artery further on. These blood clots are called emboli and can be damaging. For example, total blockage of an artery that provides a foot may lead to reduction of blood to part of the foot, which can cause pain in the foot and gangrene if left without treatment.

If the aneurysm does rupture then you are likely to have sudden severe abdominal and/or back pain. This is normally soon followed by crease as the internal bleeding causes a sharp drop in blood pressure.

The way in which an abdominal aortic aneurysm is diagnosed? Occasionally a medical doctor senses the stick out of an aneurysm while in a program examination of the abdomen. However, many AAAs are too small to medium sized to feel.An X-ray of the abdomen (often carried out for other purposes) will display calcium mineral deposits lining the wall of an AAA in several, but not all, cases.An ultrasound diagnostic scan is the easiest way to detect an AAA. This is a painless test. It is the similar option of scan that expecting a baby women have to look at the baby in the womb. The size of the aneurysm can also be measured by ultrasound. As discussed later, it is important to know the size.A more detailed scan, such as a CT scan, is sometimes done. This may be performed if your personal doctor needs to know whether the aneurysm is impacting on any of the arteries that come off the aorta. For illustration, if the aneurysm involves the section of the aorta where the arteries to the kidneys branch off, specialists need to find out this information if they plan to operate.

What is the chance of an abdominal aortic aneurysm rupturing? The chance of rupture is minimal if an AAA is minimal. As a rule, the risk of rupture increases with raising sizing. This is much like a balloon - the larger you blow it up, the greater the pressure, and the greater the probability it will burst open. The dimension of an AAA can be tested by an ultrasound check. The following gives overall threat figures for the size (diameter) of the aneurysm: 40 mm-55 mm: about a 1 in 100 chance of rupture per year.55 mm-60 mm: about a 10 in 100 chance of rupture per year.</li>60 mm-69 mm: about a 15 in 100 chance of rupture per year.</li>70 mm-79 mm: about a 35 in 100 chance of rupture per year.</li>80 mm or more: about a 50 in 100 chance of rupture per year.</li></ul> As a rule, for any given size, the risk of rupture is increased in smokers, females, those with high blood pressure, and those with a relatives historical past of an AAA.

Should everyone with an abdominal aortic aneurysm have surgical treatment? The simple answer is no. Operative repair of an AAA is a significant operation and provides dangers. A small amount of people will die during, or right after, the operation. If you have a small AAA, the probability of loss of life generated by surgical procedures is more significant than the risk of rupture. As a result, surgical treatment is normally not suggested if you have an AAA less than 50 mm wide. Even so, regular ultrasound scanning will usually be suggested to discover if it gets larger over time.

Surgery treatment is commonly proposed if you develop an AAA larger than 50 mm. For these larger aneurysms the chance of rupture is typically higher than the risk of surgical treatment. Nevertheless, if your common condition of health is poor, or if you have certain other medical conditions, this could raise the danger if you have surgical treatment. For that reason, in a number of scenarios the decision to operate may be a not easy one.

Urgent surgical treatment is required if an AAA ruptures. On average, about 8 in 10 people who have a ruptured aortic aneurysm will die due to the rapid serious bleeding. Even so, emergency surgery is lifesaving in some situations.

What surgical procedures are implemented? There are 2 types of surgery operation to restore an AAA.

The classic operation is to cut out the bad piece of aorta and change it with an synthetic element of artery (a graft). This is a major surgery and, as pointed out, provides certain risk. Some people die throughout this operation. However, it is successful in most scenarios and the aneurysm is 100 % fixed. The long-term prospect is good. The graft normally works well for the rest of your life.

A modern technique makes it possible for the aorta to be restored by a method known as endovascular repair. This has become a popular choice in current years. In this technique a tube is passed up from inside one of the leg arteries into the area of the aneurysm. This tube is then passed throughout the widened aneurysm and repaired to the good aorta wall applying metal clips. The advantage to this specific type of repair is that there is no abdominal surgical procedure. This technique is thus safer than the common operation, and you need to spend less time in the hospital. A disadvantage is that certain patients have to undergo an additional surgery at a later stage to refine the primary process.

Medical techniques keep going to develop and improve. Your doctor will advise about the advantages and negative aspects of surgery, the different types of surgery, and the best method for you.

Other treatment options could be necessary If you have an AAA, you are likely to have a significant amount of atheroma that lines the artery. For this reason, you are at threat of having significant atheroma formation in other arteries, such as the coronary (heart) arteries and brain arteries. Therefore, you are likely to be at enhanced risk of developing heart disease (angina, heart attack, etc) and stroke.

In fact, most people who develop an aortic AAA do not die of the aneurysm but die from other vascular problems, such as a heart strike or stroke.

Therefore, you should think about doing what you can to reduce the chance of these factors by other means. For example: Eat a healthy diet which consists of keeping a low salt intake.</li>If you are able, exercise often.</li>Lose excess weight if you are over weight.</li>Do not smoke.</li>If you drink alcohol, do so in moderation.</li>If you have high blood pressure, diabetes, or a high cholesterol level, they should be well controlled on treatment.</li>You may be prescribed a statin drug to lower your cholesterol level and low-dose aspirin to help prevent blood clots from forming.</li></ul> See separate booklet called Preventing Cardiovascular Diseases for more details.

Screening for abdominal aortic aneurysm Research analyses propose that a routine ultrasound check is beneficial for all men aged 65. This is mainly because most people with an AAA do not have symptoms. Following a program scan, surgery can be presented to men found to have an aneurysm over 50 mm wide. Follow-up scans can be supplied to monitor those with smaller aneurysms.

In early 2008, the government released that over the subsequent five years ultrasound screening would be rolled out to enable all men in England aged 65 and over to be screened. Screening is likely to begin in Scotland in 2011. Wales and Northern Ireland have yet to announce their plans. Screening for AAA is offered only to men, as the condition is much more typical in men than in women. One research shared in 2009 determined that if all men in their 60s and 70s were screened in England then this could save nearly 2,000 lives a year. Nevertheless, there are some people who have worries about screening for AAA; for example, see the paper by Johnson cited under 'References', below.