Aortic Aneurysms

Aortic Aneurysm Risk Factors

Aneurysms are enlargements of arteries caused by a progressive weakening of the arterial wall resulting in dilation of the vessel. One of the most common sites for aneurysm formation is the abdominal aorta. The major risk factors for an abdominal aortic aneurysm include age over 60 years, male gender, a parent or sibling with an abdominal aortic aneurysm, a history of smoking, high blood pressure and chronic lung disease.

Aortic Aneurysm Symptoms

Most abdominal aortic aneurysms are asymptomatic. Aneurysms, however, may manifest with symptoms such as intense back or abdominal pain. The major risk of an abdominal aortic aneurysm is rupture resulting in severe or fatal internal bleeding. Ruptured abdominal aortic aneurysms are the 13th leading cause of death in the United States, with over 15,000 Americans dying each year.

Aortic Aneurysm Diagnosis

Many abdominal aortic aneurysms can be diagnosed by careful physical examination. When an aneurysm is suspected, by physical examination or the patient's history, an imaging study such as a CT scan, ultrasound or magnetic resonance imagining (MRI) study of the abdomen is helpful in determining the presence, size and extent of the aortic aneurysm. In asymptomatic patients with abdominal aortic aneurysms (AAA) less than 5cm in diameter, the patient is followed with serial images taken to monitor any changes in the size of the aneurysm. Intervention is usually delayed until the aneurysm progresses to greater than 5cm in size or results in symptoms.

Aortic Aneurysm Treatment

There have been many exciting developments in the treatment of abdominal aortic aneurysms. There are two major techniques for the repair of aortic aneurysms. The traditional open surgical operation is an option available to most patients. This is a major surgical procedure performed through an abdominal incision. The aneurysm is repaired by replacing the diseased segment of the aorta with a strong and durable artificial graft which is sewn in its place. Although this is a major operation, it is an extremely durable and effective way to treat abdominal aortic aneurysms.

More recently, newer catheter-based technologies allow minimally invasive treatment of aortic aneurysms. In this technique, small incisions are made in the groin and, using x-ray control, catheters are placed internally up into the aorta. The catheters are then used to deploy aortic stent grafts which anchor above and below the aneurysm, thus repairing the aneurysm from the inside. This procedure is generally well tolerated and results in a shorter hospital stay, generally about two days. Following placement of an aortic stent graft, patients require ongoing long-term follow-up with CT scans to ensure that the grafts are functioning properly. There are certain anatomic requirements for safe placement of an aortic stent graft and not all patients have appropriate anatomy for this procedure.

View an archived webcast of Minimally Invasive Abdominal Artery Repair Surgery, performed on January 20, 2005.