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Abdominal Aortic Aneurysm An abdominal aortic aneurysm is a dilation (ballooning) of area of the aorta that is located in the abdomen. An abdominal aortic aneurysm mostly leads to no symptoms unless it ruptures (bursts). A ruptured abdominal aortic aneurysm is quite often critical. An aneurisma abdominal less than 50 mm broad comes with a low chance of rupture. A surgical procedure to take care of the aneurysm will be suggested if it is greater than 50 mm, as previously mentioned this dimension the risk of rupture raises. Individuals aged 65 and more are to be supplied a routine scan to screen for abdominal aortic aneurysm.

What is the aorta? The aorta is the most significant artery (blood vessel) in the human 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 vulnerable than a normal artery wall. The tension of the blood inside of the artery leads to the weaker section of wall to balloon.

 

Aneurysms might happen in any existing artery, but they most usually take place in the aorta. Most aortic aneurysms appear in the segment of the aorta that goes through the abdomen. These are identified as abdominal aortic aneurysms (AAAs). Sometimes they occur in the section moving via the chest. These are known as thoracic aortic aneurysms.

The standard diameter of the aorta in the abdomen is about 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 mainly about AAAs.

AAAs vary in size. As a rule, at the time you develop an AAA, it has a tendency gradually to get greater. The rate at which it gets larger ranges from person to person. However, on average, an AAA leads to get larger by around 10% every year.

What leads to an abdominal aortic aneurysm? In most cases The particular cause why an aneurysm figures in the aorta in most cases is not clear. Most situations occur in older people. An AAA is rare in people below the age of 60. Therefore, growing older has a main role to play.

The wall of the aorta typically has levels of smooth muscle mass, and layers made from tissues known as elastin and collagen. Elastin and collagen are powerful encouraging tissues. What seems to happen is that a part of the aorta loses its standard toughness and elasticity in some people as they get older. Medical studies recommends that this is because of to changes in the elastin, collagen and smooth muscle tissues. There seem to be difficult biochemical procedures that cause these changes. Some people are more susceptible than others to these changes.

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

Atheroma could additionally play a part. Atheroma is a oily material that deposits within the inside of lining of arteries. Atheroma is in some cases called furring of the arteries. Most AAAs are lined with some atheroma. Anyone can develop atheroma, but it develops more often with increasing age. A number of risk factors also improve the chance of atheroma developing. They include: smoking, high blood tension, diabetes, raised cholesterol level, taking little exercise, and obesity. These are the same risk factors that increase the probability of atheroma forming in the heart (coronary) arteries, which can cause angina and heart attacks. In a minority of cases Rare triggers of AAAs have injury or infection of the aorta. As well, certain rare hereditary conditions can affect the artery structure. In these uncommon situations an aneurysm may develop at a relatively 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 becomes more regular with raising age. Though, most people with an AAA are not knowledgeable that they have one. An AAA is uncommon in people less than the age of 60.

What is the concern about an abdominal aortic aneurysm? The main concern is that the aneurysm might rupture (burst). The wall of the aneurysm is less strong than a usual artery wall and may not be able to withstand the force 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 symptoms and signs of an abdominal aortic aneurysm? Quite often there are no warnings. At the time of medical 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 lead to any symptoms except when it gets large enough to put tension on nearby structures. If signs do happen, they are likely to be mild abdominal or backside pains. There are many factors of mild abdominal and back pain. As a result, the identification may be postponed unless the aneurysm is large enough to be felt by a doctor when he or she inspects your abdomen.

In some cases small blood clots form on the inside lining of an AAA. These may break off and be transported down the aorta and block a smaller artery further on. These blood clots are called emboli and can be harmful. For illustration, full blockage of an artery that supplies a foot may prospect to loss of blood to part of the foot, which can result in problems 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 generally soon followed by collapse as the internal bleeding causes a sharp drop in blood pressure.

How is an abdominal aortic aneurysm diagnosed? Occasionally a medical professionsal senses the bulge of an aneurysm while in a routine check-up of the abdomen. However, many AAAs are too small to feel.An X-ray of the abdomen (often performed for other causes) will indicate calcium mineral stores lining the wall of an AAA in several, but not all, scenarios.An ultrasound diagnostic scan is the easiest way to detect an AAA. This is a painless check. It is the identical type of diagnostic 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 medical expert needs to know whether the aneurysm is affecting any of the arteries that come off the aorta. For instance, if the aneurysm involves the section of the aorta where the arteries to the kidneys branch off, surgeons need to find out this information if they plan to operate.

What is the risk of an abdominal aortic aneurysm rupturing? The chance of rupture is low if an AAA is compact. As a rule, the risk of rupture improves with raising measurement. This is much like a balloon - the larger you blow it up, the greater the pressure, and the higher the chance it will burst. The diameter of an AAA can be tested by an ultrasound diagnostic scan. The following gives general 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 improved in smokers, females, those with high blood pressure, and those with a relatives historical past of an AAA.

Should every person with an abdominal aortic aneurysm have surgical treatments? The short answer is no. Operative repair of an AAA is a major treatment and carries threats. A small amount of people will die while in, or quickly after, the surgery. If you have a small AAA, the threat of death generated by surgical procedures is greater than the risk of rupture. Therefore, surgical treatment is often not suggested if you have an AAA less than 50 mm broad. However, common ultrasound scans will usually be recommended to see if it gets larger over time.

Surgical procedure is commonly proposed if you develop an AAA larger than 50 mm. For these larger aneurysms the possibility of rupture is generally higher than the risk of surgical procedures. However, if your basic state of health is bad, or if you have certain other medical related issues, this could raise the risk if you have surgical procedure. For that reason, in a number of cases the decision to operate could be a hard one.

Urgent situation surgical procedure is needed if an AAA ruptures. On average, about 8 in 10 people who have a ruptured aortic aneurysm will die due to the unexpected critical bleeding. However, emergency surgery is lifesaving in some situations.

What surgical procedures are performed? There are two types of operative treatment to restore an AAA.

The regular procedure is to cut out the negative piece of aorta and replace it by using an synthetic element of artery (a graft). This is a main operation and, as described, brings certain threat. Some people die throughout this operation. However, it is successful in the majority of situations and the aneurysm is totally repaired. The long-term prospect is fine. The graft normally works well for the rest of your life.

A newer procedure lets the aorta to be restored by a procedure termed endovascular repair. This has become a popular alternative in current years. In this method a tube is passed up from inside one of the leg arteries into the section of the aneurysm. This tube is then passed across the increased aneurysm and repaired to the good aorta wall applying metal clips. The edge to this specific type of restoration is that there is no abdominal surgical procedure. This tactic is thus safer than the classic operation, and you need to have to spend less time in the hospital. A negative aspect is that certain individuals have to undergo a further procedure at a later stage to improve the initial process.

Surgical techniques keep going to develop and improve. Your doctor will advise about the advantages and disadvantages of surgical treatment, the various types of operation, and the best solution for you.

Other treatments could be necessary If you have an AAA, you are likely to have a substantial amount of atheroma that lines the artery. Therefore, you are at probability of having substantial atheroma structure in other arteries, such as the coronary (heart) arteries and brain arteries. Therefore, you are likely to be at higher 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 some other vascular disorders, such as a heart harm or stroke.

Therefore, you should consider doing what you can to reduce the threat of these conditions by other means. For illustration: Eat a healthy diet which comes with keeping a low salt intake.</li>If you are able, exercise regularly.</li>Lose weight if you are over weight.</li>Do not smoke cigarettes.</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 leaflet called Preventing Cardiovascular Diseases for more details.

Screening for abdominal aortic aneurysm Research analyses recommend that a program ultrasound check out is worthwhile for all men aged 65. This is simply because most people with an AAA do not have symptoms. Following a routine diagnostic scan, surgery treatment can be provided 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 authorities introduced 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 common in men than in women. One research released in 2009 predicted 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.