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Abdominal Aortic Aneurysm (cont.)

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What is the natural history of abdominal aortic aneurysms?

Abdominal aortic aneurysms gradually expand over time. The larger the aneurysm, the greater the risk of rupture and death. Small aneurysms can be observed and followed with repeated ultrasounds or other imaging.

Guidelines for following an aneurysm are as follows:

  • A normal aorta measures up to 1.7 cm in a male and 1.5 cm in a female.
  • Aneurysms that are found incidentally or by accident that are less than 3.0 cm do not need to be re-evaluated or followed.
  • Aneurysms measuring 3.0 to 4.0 cm should be rechecked by ultrasound every year to monitor for potential enlargement and dilation.
  • Aneurysms measuring 4.0 to 4.5 cm should be monitored every 6 months by ultrasound.
  • Aneurysms measuring greater than 4.5 cm should be evaluated by a surgeon for potential repair.

What are the complications with an abdominal aortic aneurysm?

An aortic aneurysm can leak causing an increase in the patient's abdominal pain. When pain is felt in the back or flank, the symptoms can be misdiagnosed as a kidney stone. If the diagnosis is missed or if the patient does not present for care, the aneurysm can burst or rupture causing potential catastrophe and death.

Since aneurysms are associated with atherosclerosis and plaque along the aortic wall and since aneurysms often contain a clot, debris can travel, or embolize, into smaller blood vessels and cause symptoms due to decreased blood flow.

Aneurysms can rarely become infected.

How are abdominal aortic aneurysms repaired?

Each patient is different and the decision to repair an abdominal aortic aneurysm depends upon the size of the aneurysm, the age of the patient, underlying medical conditions, and life expectancy.

There are two approaches for repair:

The first is the traditional surgical approach. A large incision is made in the abdomen, the aortic aneurysm is identified and cut out or resected. The missing piece of aorta is replaced with a synthetic graft.

The second approach is placing an endovascular graft. A catheter or tube is threaded into the femoral artery in the groin and the graft is positioned so that it spans and sits inside the aneurysm and protects it from expanding (endovascular: endo = inside + vascular = blood vessel).

The approach to treatment needs to be tailored to the individual patient and very much depends upon the location, size, and shape of the aneurysm.

Picture of grafted stent to repair an abdominal aortic aneurysm.
Picture of grafted stent to repair an abdominal aortic aneurysm.
Medically Reviewed by a Doctor on 10/10/2012

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Abdominal Aortic Aneurysm - Experience Question: Please describe your experience with an abdominal aortic aneurysm.
Abdominal Aortic Aneurysm - Symptoms Question: What symptoms did you experience with your abdominal aortic aneurysm?
Abdominal Aortic Aneurysm - Surgery Experience Question: Did you or a relative have surgery for an abdominal aortic aneurysm? What was the outcome?
Abdominal Aortic Aneurysm - Rupture Question: Do you have a friend or relative who had a ruptured abdominal aortic aneurysm? Please share your experience.
Source: MedicineNet.com
http://www.medicinenet.com/abdominal_aortic_aneurysm/article.htm

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