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An abdominal aortic aneurysm (AAA) is an enlarged or bulging area of the aorta. This is similar to a blister in a tire or a weakening in the wall. The aorta is the largest artery in the body, carrying blood from the heart, coursing through the chest and belly, and distributing blood to the entire body. AAAs typically are located in the abdomen above the belly button, but back by the spine, making them difficult to diagnose. If you have an abdominal aortic aneurysm, your life would be at risk if it ruptures (bursts).
It’s normal to have questions if your healthcare provider suspects that you may have an abdominal aortic aneurysm. At St. Luke’s, our Heart & Vascular Center experts know what it takes to both diagnose and treat this serious condition. Healthgrades® has named us one of America’s 50 Best Hospitals for Cardiac Surgery™ since 2019 and one of America’s 50 Best Hospitals for Vascular Surgery™. We’ll make sure you have the information and support you need at every stage. We offer appointments weeks faster than other centers, with priority appointments available. Additionally, your care team will be by your side throughout the process.
How We Diagnose an Abdominal Aortic Aneurysm
Your provider may order one or more of the following tests to find out whether you have an abdominal aortic aneurysm:
- Ultrasound of the aorta is a good screening tool to help locate a suspected aneurysm for people at risk for AAA
- Computed tomography (CT) scan of the abdomen to better define the anatomy of the AAA as it gets close to the size of needing repair
- Computed tomographic angiogram (CT angiogram or CTA) to aid in planning for surgery, if needed.
If you have an abdominal aortic aneurysm that doesn’t yet need treatment, your provider may order regular abdominal ultrasounds so we can monitor the AAA closely.
Our Abdominal Aortic Aneurysm Treatment Options
Regular Monitoring
If you have a small aneurysm that isn’t causing symptoms, your doctor may recommend regular monitoring. You may need ultrasounds and/or CT scans on a regular basis to watch your aneurysm and make sure it’s not growing too quickly.
Your doctor may also recommend that you make changes to your lifestyle to help slow your aneurysm’s growth. Those changes may include:
- Stopping smoking
- Exercising regularly
- Losing weight
- Managing high blood pressure
Abdominal Aortic Aneurysm Surgery
Your doctor likely will recommend surgery to repair your aneurysm if it’s around 5 to 5.5 centimeters (1.97 to 2.17 inches) or larger. If your aneurysm is causing symptoms, even if it’s small, your doctor likely will recommend surgery. Additionally, if your aneurysm has ruptured, you will need immediate surgery to save your life, although the goal is to diagnose and treat AAAs before they rupture, because most patients with ruptured AAAs don’t survive.
Our surgeons offer two options for repairing abdominal aortic aneurysms: traditional open surgery and endovascular aneurysm repair (EVAR):
Traditional Open Surgery
Your surgeon will make a large incision on your abdomen to clamp off blood flow above and below the aneurysm site. We’ll then repair the damaged part of the aorta and insert an artificial tube called a “graft” to replace the damaged blood vessel.
EVAR (Endovascular Aortic Repair)
Fortunately, the vast majority of AAAs can be repaired endovascularly with shorter hospital stays and recovery times. In this less-invasive procedure, your surgeon will make a small incision in the groin area and, using a variety of wires and catheters, will repair the AAA from the inside of the aorta by placing a graft at the site of your aneurysm to strengthen the weakened area of the aorta and help prevent a rupture. This is similar to fixing a leaking pipe by re-lining it from the inside
Abdominal Aortic Aneurysm Symptoms
Most people don’t know they have an AAA and don’t experience any symptoms. Sometimes it can feel like your heartbeat is coming from your belly with large AAAs. It’s not until the AAA rapidly expands and ruptures that patients may notice:
- Sudden onset of pain in your lower back or belly
- Pain in the leg, groin or pelvis
If you notice any of the following symptoms, they may be signs of a ruptured aneurysm:
- Dizziness, fainting or passing out
- Fast heartbeat
Severe pain in the belly or lower back - Low blood pressure
- Nausea
Call 911 right away if you have any of these symptoms. A ruptured abdominal aortic aneurysm is a severe, life-threatening emergency.
Abdominal Aortic Aneurysm Risk Factors
High blood pressure and other heart and vascular diseases can increase your risk of developing an abdominal aortic aneurysm. Other factors that can make you more likely to have one include:
- Tobacco use: Smoking can weaken the walls of your blood vessels
- Age: Abdominal aortic aneurysms most often develop in people 65 and older. However, the aorta can begin to deteriorate or weaken to an aneurysmal dilation at any age.
- Sex: Men are more likely to have an abdominal aortic aneurysm than women
- Race: White people are more likely to have an abdominal aortic aneurysm
- Family history
- History of other aneurysms
- Interestingly, diabetes seems to be protective, and it is rare to see an AAA in a diabetic patient typically at risk for other vascular diseases