Abdominal Aortic Aneurysm (AAA)
The aorta is the largest artery in the body, and the main blood vessel
carrying blood throughout the body. An abdominal aortic aneurysm (AAA)
is an area of weakening in the wall of the artery that may begin to bulge
of dilate. This is thought to be caused by an imbalance in the build-up
and break-down of the aortic wall. If the aneurysm becomes large enough,
it may rupture.
AAA's occur in about 5% of men over the age of 60 and in women over
the age of 70. It is the 10
th leading cause of death in men over the age of 55, usually due to the rupture
(bursting) of the aneurysm; 80-90% of ruptured aneurysms result in death.
The risk factors for AAA are similar to those of atherosclerosis (build
up of fatty substances along the inner walls of the arteries).
- Age (anyone aged 50+)
- Family history of AAA
- Hypertension (high blood pressure)
- Male gender
Most patients (about 70-75%) with AAA have
If the aneurysm begins to leak or rupture, you may experience:
- Abdominal or back pain
- Flank or groin pain
- Loss of consciousness
- Low blood pressure
AAA's are often found incidentally during a routine physical examination
by feeling a pulsating mass in the abdomen or on an X-ray exam performed
for other reasons.
Imaging modalities used to diagnose and characterize AAA include:
- Angiography: an X-ray dye study often required to plan endovascular stent
- CT Scan: a specialized X-ray that shows the size and extent of the aneurysm
and is used for planning operative repair.
- Ultrasound: a noninvasive test that can determine the presence and size
of an aneurysm.
Repair is the only treatment for AAA. Small AAA's (< 5cm) should
be regularly followed with ultrasound to track changes in the size of
Endovascular grafting or open surgery is typically performed when the AAA
reaches 5cm or larger in size due to increasing
risk of rupture.