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Abdominal Aortic Aneurysm

Frequently referred to as an AAA, an abdominal aortic aneurism is a balloon-like swelling of the aorta, the main artery. The aorta carries oxygenated blood from your heart to the rest of your body, and AAA occurs in the section that passes through the abdomen, which is approximately 2cm wide, but can grow to over 5.5cm in the case of an aneurysm.

AAA affects men more often than women, and the risk of AAA increases after age 65.

Causes Abdominal aortic aneurysms are caused by a weakness in the blood vessel wall that develops over time. Much more common in men than women and more frequently appearing in those 65+, AAA can also run in families. Smokers and those with other signs of atherosclerosis (hardening of the arteries, like heart attacks and strokes), are more likely to have an AAA.

Additional risk factors you can impact: Give up smoking
Control your blood pressure
Lower your cholesterol levels
Maintain a healthy weight

Symptoms In most instances, there are no noticeable symptoms, and most people won’t be aware that they have AAA. As an aneurysm gets bigger, the feeling of a "second heartbeat" in the upper abdomen may present. If an aneurysm bleeds or ruptures, it is a life threatening emergency.

Patients will experience: a sudden severe pain in the abdomen, back or lower back area feeling cold, clammy, sweaty, faint and breathless loss of consciousness

Diagnosis Abdominal aortic aneurysm is sometimes picked up during tests for other conditions, commonly by ultrasound, CT or MRI Scan. If the AAA is large enough, and you are slim enough, it might be felt by your physician, but this is very uncommon. The current guidelines recommend that men should start having a screening ultrasound at 65, and that women who have smoked and/or have a family history of AAA should screen for it as well.

Treatment To try to prevent an AAA, or once a small AAA is identified, it is vital to live as healthy a lifestyle as possible. Quit smoking, control and monitor blood pressure and cholesterol levels, and discuss taking medications like aspirin with your doctor.

Most aneurysms are small and don’t require treatment. But if an aneurysm grows, the risk of it bursting becomes higher. If it grows to more than 5.5 cm you will be referred to a surgical specialist to discuss treatment. There are two main treatments available for AAA:

Surgical repair involves replacing the affected part of your aorta with a plastic tube (graft). It is a major operation requiring general anaesthetic, and can take some weeks to make a full recovery.

Endovascular repair (EVAR) is a type of keyhole surgery, involving placing a stent-graft (a small metal tube covered with a mesh) inside the artery through a small cut in the groin. This procedure usually uses local anaesthetic, and patients are able to get up and walk around the next day.