FordyceHamner230

Abdominal Aortic Aneurysm An abdominal aortic aneurysm is a dilation (ballooning) of area of the aorta that is within the abdomen. An abdominal aortic aneurysm almost always leads to no warning signs unless it ruptures (bursts). A ruptured abdominal aortic aneurysm is quite often critical. An aneurisma aortico much less than 50 mm wide comes with a minimal expectation of rupture. A surgical procedure to repair the aneurysm could be recommended if it is larger sized than 50 mm, as above this dimension the threat of rupture grows. Individuals 65 years old and more are to be proposed a routine scan to screen for abdominal aortic aneurysm.

What is the aorta? The aorta is the biggest 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 segment of an artery widens (balloons out). The wall of an aneurysm is vulnerable than a healthy artery wall. The tension of the blood inside the artery can cause the weaker section of wall to balloon.

 

Aneurysms might happen in any existing artery, but they most commonly take place in the aorta. Most aortic aneurysms arise in the section of the aorta that moves through the abdomen. These are known as abdominal aortic aneurysms (AAAs). In some cases they occur in the segment moving via the chest. These are known as thoracic aortic aneurysms.

The standard dimension of the aorta in the abdomen is around 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 only about AAAs.

AAAs differ in size. As a rule, once you develop an AAA, it has a tendency gradually to get larger. The speed at which it becomes larger differs from person to person. However, on average, an AAA tends to get larger by around 10% for each year.

What leads to an abdominal aortic aneurysm? In the majority of cases The exact cause why an aneurysm figures in the aorta in most cases is not well-defined. Most situations occur in aged people. An AAA is uncommon in people below the age of 60. For that reason, growing older has a main role to play.

The wall of the aorta commonly has levels of sleek muscle, and layers built from tissues termed elastin and collagen. Elastin and collagen are powerful supporting tissues. What seems to happen is that a part of the aorta loses its natural toughness and flexibility 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 complicated biochemical processes that cause these modifications. Some people are more prone than others to these changes.

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

Atheroma could as well play a part. Atheroma is a oily material that stores within the inside lining of arteries. Atheroma is from time to time termed furring of the arteries. Most AAAs are lined with some atheroma. Anyone can develop atheroma, but it develops more usually with raising age. A number of risk variables also enhance the chance of atheroma developing. 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 chance of atheroma forming in the heart (coronary) arteries, which can cause angina and heart attacks. In a minority of cases Rare triggers of AAAs include injury or infection of the aorta. In addition, certain uncommon inherited conditions can affect the artery framework. In these abnormal situations an aneurysm may develop at a quite 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 will become more common with increasing age. In spite of this, most people with an AAA are not careful that they have one. An AAA is not usual 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 normal artery wall and may not be able to resist 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 indicators of an abdominal aortic aneurysm? Often there are no signals or 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 result in any symptoms unless it becomes large sufficient to put force on nearby structures. If signs or symptoms do take place, they are possible to be mild abdominal or backside aches and pains. There are many causes of mild abdominal and back pain. For this reason, the diagnosis may be postponed unless the aneurysm is large enough to be felt by a doctor when he or she inspects your abdomen.

Occasionally small blood clots form on the inside lining of an AAA. These may break off and be taken down the aorta and block a smaller artery further on. These blood clots are called emboli and can be damaging. For illustration, full blockage of an artery that supplies a foot may prospect to reduction of blood to part of the foot, which can cause 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 crease as the internal bleeding causes a sharp drop in blood pressure.

The best way in which an abdominal aortic aneurysm is diagnosed? Sometimes a medical professionsal senses the bulge of an aneurysm throughout a routine examination of the abdomen. Nevertheless, many AAAs are too compact to feel.An X-ray of the abdomen (often performed for different purposes) will display calcium stores lining the wall of an AAA in several, but not all, situations.An ultrasound check is the easiest way to detect an AAA. This is a painless analyze. It is the identical 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 done if your current doctor requires to know whether the aneurysm is influencing 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, specialists need to know this information if they prepare to operate.

What is the danger of an abdominal aortic aneurysm rupturing? The chance of rupture is minimal if an AAA is minimal. As a rule, the risk of rupture increases with growing 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 open. The diameter of an AAA can be assessed by an ultrasound check out. 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 background of an AAA.

Should really everybody with an abdominal aortic aneurysm have surgical procedure? The brief answer is no. Operative restoration of an AAA is a significant operation and provides dangers. A small quantity of people will die during, or shortly after, the surgery. If you have a small AAA, the risk of dying generated by surgery is more significant than the risk of rupture. For this reason, medical procedures is often not advised if you have an AAA less than 50 mm broad. Nevertheless, regular ultrasound tests will generally be suggested to observe if it gets larger over time.

Surgical procedures is commonly suggested if you develop an AAA larger than 50 mm. For these larger aneurysms the threat of rupture is commonly higher than the risk of surgical treatments. Even so, if your common condition of health is bad, or if you have specified other health care problems, this could improve the risk if you have medical procedures. So, in several situations the final decision to operate could be a not easy one.

Urgent situation surgical treatment 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 significant bleeding. Nevertheless, emergency surgery is lifesaving in some cases.

What operations are practiced? There are a pair of types of surgery treatment to fix an AAA.

The regular procedure is to cut out the bad piece of aorta and swap it by using an synthetic piece of artery (a graft). This is a major procedure and, as mentioned, carries some threat. Some people die for the duration of this operation. Even so, it is productive in a lot of scenarios and the aneurysm is completely fixed. The long-term prospect is fine. The graft generally works well for the rest of your life.

A modern technique allows the aorta to be restored by a technique known as 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 fixed to the good aorta wall using metal clips. The edge to this specific type of fix is that there is no abdominal surgery. This method is thus more secure than the classic operation, and you need to have to spend less time in medical center. A disadvantage is that some individuals have to undergo a further operation at a later stage to perfect the early procedure.

Operative methods continue to develop and improve. Your surgeon will suggest about the pros and disadvantages of surgical treatment, the various forms of procedure, and the best option for you.

Other treatment options could be necessary If you have an AAA, you are most likely to have a substantial amount of atheroma that lines the artery. Therefore, you are at threat of having substantial atheroma formation 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 additional vascular conditions, such as a heart attack or stroke.

Therefore, you should think of doing what you can to decrease the danger of these factors by other means. For illustration: Eat a healthy diet which consists of keeping a low salt intake.</li>If you are able, exercise regularly.</li>Lose 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 propose that a routine ultrasound scan is worthwhile for all men aged 65. This is for the reason that most people with an AAA do not have symptoms. Following a program diagnostic scan, surgical procedure can be offered to men found to have an aneurysm over 50 mm wide. Follow-up scans can be provided 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 typical 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. 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.