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Abdominal Aortic Aneurysm An abdominal aortic aneurysm is a dilation (ballooning) of section of the aorta that is within the abdomen. An abdominal aortic aneurysm in most cases causes no signs of illness except when it ruptures (bursts). A ruptured abdominal aortic aneurysm is quite often fatal. An aneurisma aortico much less than 50 mm broad has a decreased probability of rupture. An operation to repair the aneurysm may be advised if it is greater than 50 mm, as previously mentioned this dimension the chance of rupture improves. Males 65 years old and more are to be proposed a program 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 causes the weaker section of wall to balloon.

 

Aneurysms could occur in any artery, but they most commonly take place in the aorta. Most aortic aneurysms occur in the area of the aorta that passes through the abdomen. These are recognized as abdominal aortic aneurysms (AAAs). Sometimes they occur in the section moving through the chest. These are known as thoracic aortic aneurysms.

The normal dimension of the aorta in the abdomen is about 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 booklet is mainly about AAAs.

AAAs range in measurement. As a rule, at the time you develop an AAA, it leads progressively to get bigger. The rate at which it gets larger ranges from person to person. However, on average, an AAA leads to get larger by about 10% per year.

What leads to an abdominal aortic aneurysm? In the majority of cases The actual cause why an aneurysm figures in the aorta in most cases is not well-defined. Most scenarios happen in aged people. An AAA is extraordinary in people less than the age of 60. For that reason, growing older has a significant role to play.

The wall of the aorta commonly has layers of smooth muscle mass, and layers created from tissues named elastin and collagen. Elastin and collagen are powerful supporting tissues. What seems to happen is that a part of the aorta loses its regular strength and elasticity in some people as they get older. Researches advises that this is because of to changes in the elastin, collagen and smooth muscle tissues. There seem to be complicated biochemical procedures that lead to these changes. Some people are more vulnerable than others to these changes.

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

Atheroma may as well play a part. Atheroma is a fatty substance that deposits within the inside lining of arteries. Atheroma is in some cases termed furring of the arteries. Most AAAs are lined with some atheroma. Anyone can develop atheroma, but it develops more generally with raising age. Several risk variables also enhance the chance of atheroma growing. They include: tobacco use, 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 factors of AAAs include injury or infection of the aorta. As well, certain unusual genetic factors can affect the artery structure. In these uncommon situations an aneurysm may develop at a relatively 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 will become more normal with increasing age. However, most people with an AAA are not knowledgeable that they have one. An AAA is not usual in people below the age of 60.

What is the concern about an abdominal aortic aneurysm? The main concern is that the aneurysm could rupture (burst). The wall of the aneurysm is weaker than a normal artery wall and may not be able to stand up to the tension of blood inside. 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 signs of an abdominal aortic aneurysm? Quite often there are no symptoms. 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 cause any symptoms unless of course it gets large enough to put force on native structures. If symptoms do occur, they are possible to be mild abdominal or backside discomfort. There are many triggers of mild abdominal and back pain. For this reason, the medical diagnosis could be delayed except when the aneurysm is large enough to be sensed by a medical expert when he or she examines 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 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 result in problems in the foot and gangrene if left untreated.

If the aneurysm does rupture then you are likely to have sudden severe abdominal and/or back pain. This is normally soon followed by failure as the internal bleeding causes a sharp drop in blood pressure.

The best way in which an abdominal aortic aneurysm is diagnosed? In some cases a medical professionsal feels the bulge of an aneurysm during a program examination of the abdomen. Nevertheless, many AAAs are too compact to feel.An X-ray of the abdomen (often performed for other causes) will indicate calcium deposits lining the wall of an AAA in a few, but not almost all, scenarios.An ultrasound check is the easiest way to detect an AAA. This is a painless check. It is the same type of scan that pregnant 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 accomplished if your medical expert demands to know whether the aneurysm is affecting any of the arteries that come off the aorta. For example, if the aneurysm involves the section of the aorta where the arteries to the kidneys branch off, surgeons need to recognize this information if they prepare to operate.

What is the option of an abdominal aortic aneurysm rupturing? The opportunity of rupture is low if an AAA is minimal. As a rule, the risk of rupture improves with increasing measurement. This is much like a balloon - the larger you blow it up, the greater the tension, and the higher the chance it will burst open. The dimension of an AAA can be tested by an ultrasound scan. The following gives over-all danger 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 increased in smokers, females, those with high blood pressure, and those with a family history of an AAA.

Should really every person with an abdominal aortic aneurysm have surgery treatment? The quick answer is no. Medical restoration of an AAA is a major procedure and carries dangers. A small amount of people will die during, or shortly after, the operation. If you have a small AAA, the danger of death caused by surgical procedure is greater than the risk of rupture. For that reason, medical procedures is usually not recommended if you have an AAA less than 50 mm wide. Nevertheless, usual ultrasound tests will generally be recommended to see if it gets larger over time.

Surgery is commonly suggested if you develop an AAA larger than 50 mm. For these larger aneurysms the danger of rupture is often higher than the risk of surgery treatment. However, if your basic condition of health is bad, or if you have certain other medical problems, this could raise the threat if you have surgical treatment. For that reason, in a number of scenarios the final decision to operate may be a not easy one.

Urgent situation surgical procedure is required if an AAA ruptures. On average, about 8 in 10 people who have a ruptured aortic aneurysm will die due to the immediate severe bleeding. Nevertheless, crisis surgery is lifesaving in some situations.

What procedures are executed? There are a pair of types of surgical procedure to fix an AAA.

The regular surgery is to cut out the bad piece of aorta and swap it by using an synthetic section of artery (a graft). This is a main operation and, as pointed out, includes certain threat. Some people die for the duration of this operation. However, it is successful in most scenarios and the aneurysm is completely fixed. The long-term outlook is fine. The graft normally works well for the rest of your life.

A modern procedure lets the aorta to be fixed by a technique termed endovascular repair. This has become a popular solution in the latest years. In this technique 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 widened aneurysm and repaired to the good aorta wall using metal clips. The advantage to this style of restoration is that there is no abdominal surgical procedure. This tactic is therefore less dangerous than the standard procedure, and you need to have to spend less time in clinic. A negative aspect is that some patients have to undergo a further surgery at a later stage to improve the primary process.

Surgical techniques keep going to develop and improve. Your surgeon will recommend about the advantages and negatives of surgical procedure, the different forms of surgery, and the best option for you.

Other treatment options may be necessary If you have an AAA, you are likely to have a significant amount of atheroma that lines the artery. For that reason, you are at probability of having substantial atheroma in other arteries, such as the coronary (heart) arteries and brain arteries. Therefore, you are likely to be at improved 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 other vascular problems, such as a heart strike or stroke.

Therefore, you should consider doing what you can to minimize the danger of these conditions by other means. For example: Eat a healthy diet which consists of keeping a low salt intake.</li>If you are able, exercise often.</li>Lose excess weight if you are over weight.</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 booklet called Preventing Cardiovascular Diseases for more details.

Screening for abdominal aortic aneurysm Research studies advise that a routine ultrasound scan is beneficial for all men aged 65. This is simply 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 authorities released 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 widespread in men than in women. One study 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. On the other hand, there are some people who have worries about screening for AAA; for example, see the paper by Johnson cited under 'References', below.