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OVERVIEW

What is an abdominal aortic aneurysm (AAA)?

The main blood vessel in your body is the aorta. It is a long blood vessel that reaches from your chest into your abdomen. It carries blood from your heart to the rest of your body. The part of the aorta in your abdomen is called the abdominal aorta. It supplies blood to your stomach, pelvis and legs.

Sometimes an area of a blood vessel wall will get weak. It can start to swell like a balloon and become abnormally large. This is called an aneurysm. If an aneurysm forms on your abdominal aorta and grows too large, your aorta may tear or burst.

SYMPTOMS

Symptoms of an AAA?

As the aneurysm develops, there are usually no symptoms. This can go on slowly for years. Often, AAAs don’t cause symptoms unless they leak, tear, or rupture. If this happens, you may experience:

• Sudden pain in your abdomen, groin, back, legs or buttocks
• Nausea and vomiting
• Abnormal stiffness in your abdominal muscles
• Problems with urination or bowel movements.
• Clammy, sweaty skin

CAUSES & RISK FACTORS

What Causes an AAA?

Healthcare providers don’t know what exactly causes an AAA.  Weaker aorta walls increase your chance of developing an aneurysm. There are many conditions that can weaken the walls of the aorta. These include aging, smoking, and high blood pressure. If any of the following factors apply to you, you are at higher risk of having an AAA.

• Being male. Men are more likely than women to develop an AAA.
• AAAs are more common in people age 60 or older.
• Personal history. If you have had aneurysms of any kind, you are at greater risk of an AAA.
• Smoking damages and weakens the aorta walls.
• High blood pressure. Having high blood pressure weakens the walls of your aorta.
• Family history. If any family members have had AAAs, you are at higher risk. You also could get an AAA before you are 60.

Contact your healthcare provider if you have a higher risk for an AAA, or if you have any of the symptoms.

DIAGNOSIS & TESTS

How is an AAA diagnosed?

Healthcare providers commonly find AAAs by chance during a routine exam. They also find them when doing tests for other issues, including unrelated pain in your abdomen.  The Canadian Society for Vascular Surgery currently recommends that all males at 65 should have a screening ultrasound. Many would recommend screening for women who have smoked and/or have a family history of AAA.

If your healthcare provider finds or thinks you have an AAA, they may order tests. Common tests include:

• Ultrasound or echocardiogram – These use sound waves to create pictures of the inside of your body.
• Computed tomography (CT) scan – These use X-rays to take pictures of your organs. Dye is injected into your veins so they can be seen clearly.
• Magnetic resonance imaging (MRI) – This test uses magnets and radio waves to create pictures of your organs.
• Angiography – This test uses dye and X-rays to look at the inside of your arteries. This can help your healthcare provider see how much damage or blockage there is in your blood vessels

TREATMENT

Can an AAA be prevented or avoided?

You can’t always prevent an AAA from forming. But there are steps you can take to lower your risk. These include:

• Don’t smoke. If you are a smoker, try to quit.
• Eat a healthy diet.
• Be physically active.
• Manage conditions such as high blood pressure that can be controlled with medicine

AAA treatment

Treatment for an AAA depends on its size. If your aneurysm is small, it might not need to be treated. Your healthcare provider may just monitor it using routine testing. If your healthcare provider is concerned about it, they may prescribe medicine. These can be used to lower blood pressure or relax blood vessels. This can help prevent the AAA from rupturing.

If your aneurysm is large or is growing quickly, you will most likely need surgery.  There are 2 main kinds of surgery to remove or repair AAAs:

• Open abdominal surgery – This is the most common form of surgery for an AAA. The surgeon will make an incision (cut) in your abdomen. They will remove the aneurysm. The removed section of the aorta is replaced with a graft made of man-made material.
• Endovascular repair – In this procedure, the doctor inserts a graft into the aorta to strengthen it. They will insert a catheter (tube) into your artery through your leg. The graft will be threaded through the aneurysm and expanded. This will reinforce the weak section of the aorta and allow blood to flow normally. This helps keep the AAA from rupturing.

The type of surgery you have depends on many factors. Discuss with your healthcare provider which kind is best for you.

FOR MORE INFORMATION

Visit The Canadian Society for Vascular Surgery at: https://canadianvascular.ca/Abdominal-Aortic-Aneurysms