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Abdominal Aortic Aneurysm An abdominal aortic aneurysm is a dilation (ballooning) of segment of the aorta that is within the abdomen. An abdominal aortic aneurysm usually causes no indicators unless it ruptures (bursts). A ruptured abdominal aortic aneurysm is usually dangerous. An aneurisma abdominal much less than 50 mm broad comes with a low probability of rupture. An operation to fix the aneurysm may be recommended if it is greater than 50 mm, as earlier mentioned this dimension the chance of rupture grows. Individuals aged 65 and over are to be proposed a program scan to screen for abdominal aortic aneurysm.

What is the aorta? The aorta is the largest 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 section of an artery widens (balloons out). The wall of an aneurysm is vulnerable than a normal artery wall. The force of the blood inside of the artery results in the weaker section of wall to balloon.

 

Aneurysms might occur in any artery, but they most typically occur in the aorta. Most aortic aneurysms arise in the area of the aorta that goes through the abdomen. These are identified as abdominal aortic aneurysms (AAAs). In some cases they occur in the area moving via the chest. These are known as thoracic aortic aneurysms.

The normal diameter of the aorta in the abdomen is related to 20 mm. An abdominal aortic aneurysm is said to be present if a area 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, after you strengthen an AAA, it has a tendency gradually to get larger. The rate at which it gets larger varies from person to person. In spite of this, on average, an AAA tends to get larger by about 10% every year.

What leads to an abdominal aortic aneurysm? In the majority of cases The exact factor why an aneurysm figures in the aorta in most cases is not well-defined. Most situations happen in aged people. An AAA is extraordinary in people below the age of 60. So, growing old has a major role to play.

The wall of the aorta ordinarily has levels of easy muscle, and layers made from tissues called elastin and collagen. Elastin and collagen are strong encouraging tissues. What seems to happen is that a part of the aorta loses its natural toughness and elasticity in some people as they grow older. Researches suggests that this is because of to changes in the elastin, collagen and smooth muscle tissues. There seem to be difficult biochemical processes that trigger these transformations. Some people are more vulnerable than others to these changes.

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

Atheroma could additionally play a part. Atheroma is a oily material that stores within the inside lining of arteries. Atheroma is in some cases called furring of the arteries. Most AAAs are lined with some atheroma. Anybody can develop atheroma, but it develops more typically with growing age. Several risk factors also enhance the chance of atheroma growing. They include: smoking, high blood tension, 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 factors of AAAs include injury or infection of the aorta. Additionally, certain uncommon hereditary conditions can affect the artery structure. In these uncommon situations an aneurysm may develop at a rather young age.

How regularly occurring 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 increasing age. In spite of this, most people with an AAA are not careful that they have one. An AAA is unusual 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 resist 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 warning signs of an abdominal aortic aneurysm? Often there are no signals or symptoms. 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 lead to any symptoms except when it becomes large sufficient to set up tension on nearby structures. If signs or symptoms do appear, they are most likely to be mild abdominal or backside aches and pains. There are many causes of mild abdominal and back pain. For that reason, the diagnosis could be postponed until the aneurysm is big enough to be sensed by a medical professional 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 carried down the aorta and obstruct a smaller artery further on. These blood clots are called emboli and can be threatening. For illustration, full blockage of an artery that delivers a foot may prospect to reduction of blood to part of the foot, which can cause 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 commonly soon followed by failure as the internal bleeding causes a sharp drop in blood pressure.

How is an abdominal aortic aneurysm diagnosed? Sometimes a doctor senses the stick out of an aneurysm while in a program checking of the abdomen. Even so, many AAAs are too small to medium sized to feel.An X-ray of the abdomen (often performed for different purposes) will indicate calcium mineral stores lining the wall of an AAA in several, but not almost all, scenarios.An ultrasound check is the easiest way to detect an AAA. This is an uncomplicated check. It is the same kind of check out 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 executed if your personal medical expert needs to know whether the aneurysm is affecting 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, surgeons need to find out this info if they prepare to operate.

What is the threat of an abdominal aortic aneurysm rupturing? The opportunity of rupture is low 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 tension, and the greater the probability it will burst. The diameter of an AAA can be measured by an ultrasound check out. 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 improved in smokers, females, those with high blood pressure, and those with a relatives historical past of an AAA.

Should certainly everybody with an abdominal aortic aneurysm have surgical procedure? The short answer is no. Surgery repair of an AAA is a major procedure and includes dangers. A small quantity of people will die while in, or shortly after, the treatment. If you have a small AAA, the risk of death caused by surgical procedures is more significant than the danger of rupture. Therefore, surgical procedures is normally not recommended if you have an AAA less than 50 mm wide. Even so, usual ultrasound tests will generally be advised to discover if it gets larger over time.

Medical procedures is generally advised if you develop an AAA larger than 50 mm. For these larger aneurysms the probability of rupture is usually higher than the risk of surgical treatment. Nevertheless, if your general condition of wellness is poor, or if you have specific other medical problems, this may raise the danger if you have surgery. So, in certain cases the final decision to operate may be a hard one.

Urgent situation surgical procedures is needed if an AAA ruptures. On average, about 8 in 10 people who have a ruptured aortic aneurysm will die due to the sudden severe bleeding. Even so, urgent surgery is lifesaving in some scenarios.

What surgical procedures are performed? There are two types of surgery operation to restore an AAA.

The regular procedure is to cut out the negative part of aorta and replace it by using an artificial section of artery (a graft). This is a main operation and, as described, carries some danger. Some people die throughout this operation. Even so, it is effective in the majority of situations and the aneurysm is completely fixed. The long-term outlook is fine. The graft generally works well for the rest of your life.

A current procedure makes it possible for the aorta to be repaired by a method called endovascular repair. This has become a popular option in latest 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 style of repair is that there is no abdominal surgical procedure. This technique is thus less dangerous than the classic surgery, and you require to spend less time in medical center. A negative aspect is that some individuals have to undergo an additional procedure at a later stage to refine the initial surgery.

Operative techniques continue to develop and improve. Your doctor will recommend about the positives and negatives of surgical treatment, the various kinds of surgery, and the best option for you.

Other solutions could be necessary If you have an AAA, you are likely to have a substantial amount of atheroma that lines the artery. For this reason, you are at danger of having significant atheroma formation in other arteries, such as the coronary (heart) arteries and brain arteries. Therefore, you are likely to be at increased 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 attack or stroke.

Therefore, you should think about doing what you can to reduce the chance of these conditions by other suggests. For example: Eat a healthy diet which comes with keeping a low salt intake.</li>If you are able, exercise often.</li>Lose weight if you are overweight.</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 leaflet called Preventing Cardiovascular Diseases for more details.

Screening for abdominal aortic aneurysm Research studies propose that a routine ultrasound check out is worthwhile for all men aged 65. This is because most people with an AAA do not have symptoms. Following a program diagnostic scan, surgical procedure can be available to men found to have an aneurysm over 50 mm wide. Follow-up scans can be offered to monitor those with smaller aneurysms.

In early 2008, the governing administration 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 determined that if all men in their 60s and 70s were screened in England then this could save nearly 2,000 lives a year. However, there are some people who have concerns about screening for AAA; for example, see the paper by Johnson cited under 'References', below.