DuenasTurcotte953

Abdominal Aortic Aneurysm An abdominal aortic aneurysm is a dilation (ballooning) of section of the aorta that is located in the abdomen. An abdominal aortic aneurysm usually triggers no warning signs except when it ruptures (bursts). A ruptured abdominal aortic aneurysm is quite often fatal. An abdominal aortic aneurysm less than 50 mm broad has a minimal probability of rupture. A procedure to fix the aneurysm may be advised if it is larger sized than 50 mm, as previously mentioned this size the danger 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 sized artery (blood vessel) in the 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 weaker than a natural artery wall. The tension of the blood in the artery results in the weaker section of wall to balloon.

 

Aneurysms could occur in any existing artery, but they most usually occur in the aorta. Most aortic aneurysms arise in the segment of the aorta that goes through the abdomen. These are recognized as abdominal aortic aneurysms (AAAs). Sometimes they occur in the section heading via 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 section of the aorta within the abdomen is 30 mm or more in diameter.

The rest of this booklet is only about AAAs.

AAAs vary in measurement. As a rule, after you develop an AAA, it tends gradually to get larger. The rate at which it becomes larger varies from person to person. However, on average, an AAA tends to get larger by around 10% for each year.

What causes an abdominal aortic aneurysm? In most cases The particular reason why an aneurysm forms in the aorta in most cases is not clear. Most scenarios happen in older people. An AAA is rare in people less than the age of 60. Therefore, ageing has a main factor to play.

The wall of the aorta typically has layers of smooth muscle mass, and layers created from tissues named elastin and collagen. Elastin and collagen are strong assisting tissues. What seems to happen is that a part of the aorta loses its usual strength and elasticity in some people as they grow older. Researching advises that this is due to changes in the elastin, collagen and smooth muscle tissues. There seem to be difficult biochemical processes that lead to these changes. Some people are more susceptible than others to these changes.

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

Atheroma may additionally play a part. Atheroma is a fatty material that deposits within the inside of lining of arteries. Atheroma is from time to time called furring of the arteries. Most AAAs are lined with some atheroma. Anyone can develop atheroma, but it develops more usually with increasing age. A number of risk aspects also increase the chance of atheroma forming. They include: smoking, high blood pressure, diabetes, raised cholesterol level, taking little exercise, and obesity. These are the same risk factors that enhance the probability of atheroma forming in the heart (coronary) arteries, which can cause angina and heart attacks. In a minority of cases Rare causes of AAAs include injury or infection of the aorta. In addition, certain unusual hereditary circumstances can influence the artery framework. In these abnormal situations an aneurysm may develop at a relatively young age.

How common 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 common with raising age. In spite of this, most people with an AAA are not aware that they have one. An AAA is not usual in people under 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 withstand 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 warning 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 trigger any symptoms unless it gets large enough to put pressure on native structures. If signs do appear, they are possible to be mild abdominal or backside aches and pains. There are many triggers of mild abdominal and back pain. As a result, the diagnosis may be delayed except when the aneurysm is large enough to be sensed by a doctor when he or she inspects your abdomen.

Sometimes small blood clots form on the inside lining of an AAA. These may break up off and be stocked down the aorta and obstruct a smaller artery further on. These blood clots are called emboli and can be dangerous. For instance, full blockage of an artery that supplies a foot may lead to loss of blood to part of the foot, which can cause pain 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 way in which an abdominal aortic aneurysm is diagnosed? Sometimes a medical professionsal senses the stick out of an aneurysm in the course of a routine exam of the abdomen. Even so, many AAAs are too small to medium sized to feel.An X-ray of the abdomen (often done for different reasons) will show calcium mineral stores lining the wall of an AAA in a few, but not all, situations.An ultrasound scan is the easiest way to detect an AAA. This is an uncomplicated test out. It is the exact same option of capture 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 executed if your current doctor requires to know whether the aneurysm is impacting on any of the arteries that come off the aorta. For instance, 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 plan to operate.

What is the risk of an abdominal aortic aneurysm rupturing? The opportunity of rupture is lower if an AAA is small. As a rule, the risk of rupture increases with increasing dimensions. This is much like a balloon - the larger you blow it up, the greater the tension, and the greater the chance it will burst open. The size of an AAA can be assessed by an ultrasound diagnostic scan. The following gives over-all 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 really every person with an abdominal aortic aneurysm have surgery? The brief answer is no. Operative repair of an AAA is a significant procedure and carries dangers. A small amount of people will die while in, or shortly after, the procedure. If you have a small AAA, the threat of loss of life generated by surgery is more significant than the threat of rupture. For that reason, medical procedures is often not recommended if you have an AAA less than 50 mm broad. However, regular ultrasound verification will commonly be advised to observe if it gets larger over time.

Medical procedures is commonly recommended if you develop an AAA larger than 50 mm. For these larger aneurysms the probability of rupture is typically higher than the risk of surgical procedure. But, if your general condition of wellness is weak, or if you have specific other medical problems, this could improve the risk if you have surgical procedure. So, in certain situations the final decision to operate could be a really difficult one.

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

What operations are practiced? There are two types of operative procedure to fix an AAA.

The regular operation is to cut out the bad part of aorta and replace it with an synthetic element of artery (a graft). This is a main operation and, as described, includes some risk. Some people die throughout this operation. However, it is productive in the majority of cases and the aneurysm is completely fixed. The long-term view is good. The graft normally works well for the rest of your life.

A modern method allows the aorta to be fixed by a procedure called endovascular repair. This has become a popular alternative in recent 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 increased aneurysm and repaired to the good aorta wall applying metal clips. The edge to this specific type of repair is that there is no abdominal surgical procedure. This tactic is thus safer than the traditional operation, and you need to spend less time in clinic. A negative aspect is that some persons have to undergo a further surgery at a later stage to refine the early surgery.

Surgery tactics keep going to develop and improve. Your doctor will advise about the positives and negatives of surgical procedure, the various kinds of procedure, and the best choice for you.

Other solutions could be important If you have an AAA, you are most likely to have a significant amount of atheroma that lines the artery. For that reason, you are at threat of having substantial atheroma structure in other arteries, such as the coronary (heart) arteries and brain arteries. Therefore, you are likely to be at enhanced 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 disorders, such as a heart harm or stroke.

Therefore, you should consider doing what you can to minimize the risk of these conditions by other means. For illustration: 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 over weight.</li>Do not smoke cigarettes.</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 program ultrasound check out is worthwhile for all men aged 65. This is simply because most people with an AAA do not have symptoms. Following a routine scan, surgical procedure can be presented to men found to have an aneurysm over 50 mm wide. Follow-up scans can be supplied to monitor those with smaller aneurysms.

In early 2008, the governing administration announced 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 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.