Abdominal aortic aneurysm

• Illustrations
• Alternative names
• Definition
• Causes, incidence, and risk factors
• Symptoms
• Signs and tests

• Treatment
• Expectations (prognosis)
• Complications
• Calling your health care provider
• Prevention

Alternative names    Return to top

Definition    Return to top

An aneurysm is when a blood vessel becomes abnormally large or balloons outward. The abdominal aorta is a large blood vessel that supplies blood to your abdomen, the pelvis, and legs.

Causes, incidence, and risk factors    Return to top

The exact cause is unknown, but risk factors for developing an aortic aneurysm include high blood pressure, smoking, high cholesterol, and obesity.

An abdominal aortic aneurysm can develop in anyone, but it is most frequently seen in people over 50 with one or more risk factors. The larger the aneurysm, the more likely it is to rupture.

When an abdominal aortic aneurysm ruptures, it is a true medical emergency. Aortic dissection occurs when the innermost lining of the artery tears and blood leaks into the wall of the artery.

Symptoms    Return to top

Aneurysms develop slowly over many years and often have no symptoms. If an aneurysm expands rapidly, tears open (ruptured aneurysm), or blood leaks along the wall of the vessel (aortic dissection), symptoms may develop suddenly.

The symptoms of rupture include:

• Pulsating sensation in the abdomen
• Pain in the abdomen  that is severe, sudden, persistent, or constant. The pain may radiate to groin, buttocks, or legs.
• Abdominal rigidity
• Pain in the lower back that is severe, sudden, and persistent. The pain may radiate to the buttocks, or legs.
• Anxiety
• Nausea and vomiting
• Clammy skin
• Rapid heart rate when rising to a standing position
• Shock
• Abdominal mass

Signs and tests    Return to top

Your doctor will examine your abdomen. The exam also will include an evaluation of pulses and sensation in your legs.

Abdominal aortic aneurysm may be diagnosed with these tests:

• Abdominal ultrasound
• CT scan of abdomen
• Angiography of aorta

Treatment    Return to top

If the aneurysm is small and there are no symptoms (for example, if it was discovered during a routine physical), your doctor may recommend periodic evaluation. This usually includes a yearly ultrasound, to see if the aneurysm is getting bigger.

Aneurysms that cause symptoms usually require surgery to prevent complications.

Surgery is recommended for patients with aneurysms bigger than 5 cm in diameter and aneurysms that rapidly increase in size. The goal is to perform surgery before complications develop.

There are two approaches to surgery. In a traditional (open) repair, a cut is made in your abdomen. The abnormal vessel is replaced with a graft made of synthetic material, such as Dacron.

The other approach is called endovascular repair. Thin, hollow tubes called catheters are inserted through arteries in your groin. These tubes allow the grafts to be placed without making a large cut in your abdomen. In addition, you may recover sooner. However, not all patients with abdominal aortic aneurysms are candidates for endovascular repair.

Expectations (prognosis)    Return to top

The outcome is usually good if an experienced surgeon repairs the aneurysm before it ruptures. However, less than 50% of patients survive a ruptured abdominal aneursym.

Complications    Return to top

• Aortic rupture
• Hypovolemic shock
• Arterial embolism
• Kidney failure
• Heart attack
• Stroke
• Aortic dissection

Calling your health care provider    Return to top

Go to the emergency room or call 911 if you develop severe abdominal pain or any of the other symptoms of an aneurysm.

Prevention    Return to top

Exercise, eat well, and avoid tobacco to reduce the risk of developing aneurysms.