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AAA—Not the Grade You Want

By Dr. Michael Gaffud

During your time in school, you may have tried to earn all A’s. But when it comes to your health, an AAA is not what you want to be diagnosed with. An Abdominal Aortic Aneurysm, or AAA, occurs when the wall of the aorta progressively weakens and begins to bulge or balloon. The aorta is the largest artery in the body and starts at the heart, and moves through the chest into the abdomen. The abdominal aorta delivers blood to the kidneys, intestines and legs. If left untreated, a large aneurysm can rupture causing internal bleeding and death.

Abdominal Aortic Aneurysm can be safely treated with early diagnosis. In some instances, the aneurysm is small (less than 5.5 cm or 2.2 inches), it can be safely monitored by a vascular surgeon with ultrasound or CT scans. In other instances, a vascular surgeon may recommend treatment to prevent rupture.

Most people feel no symptoms associated with their aneurysm and the aneurysm is detected during a routine physical exam or when a test accidentally finds the aneurysm. Some patients may notice a pulsing feeling near the navel. A patient that has severe tearing pain in back or abdomen needs to be evaluated urgently or emergently to prevent rupture.

The weakening of the wall that causes aneurysms is caused by breakdown in proteins that provide structural strength to the wall. Factors that contribute to the breakdown include:

  • Age
  • Male Gender
  • Family History of Aneurysm
  • Hardening of the Arteries (atherosclerosis)
  • High Blood Pressure
  • Smoking
  • Chronic Lung Disease or COPD

When treatment becomes necessary, there are two treatment options: open surgical repair or endovascular repair. Open surgical repair is the traditional method for repair. The vascular surgeon makes an incision in the abdomen and replaces the aorta with a synthetic tube graft. Endovascular repair, sometimes referred to as the stent repair, is a less invasive repair for the aneurysm. The endovascular repair involves placing a stent inside the diseased aorta to divert blood flow away from the diseased wall. This takes pressure off the wall. The stent repair can be done with small incisions in the arteries of the legs. 


Topics and Subtopics: Arteries & Veins

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