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What is an Abdominal Aortic Aneurysm (AAA)?


AAA is a weakening of the arterial wall, which can eventually lead to rupture of the blood vessel. Many of these occur in the abdomen below the umbilicus and are a common cause of death. These weakened areas expand over time and eventually rupture abruptly with only about 20% chance of survival. The anatomical effect on the artery is reminiscent of an old inner tube in a tire with the bubble ready to burst.

AAA’s tend to occur more often in men who are older and who have a history of hypertension, atherosclerosis, coronary heart disease, smoking, or a family history of AAA. Most often, they are difficult to diagnose by direct examination and usually a-symptomatic until the time of rupture. At the time of rupture, most patients experience severe abdominal pain radiating to the back, and associated with complete vascular collapse. When the diagnosis is made before rupture it is usually an incidental finding at a time of a cat scan, sonogram, or other imaging study, done primarily for another reason. Thus, the challenge lies in early diagnosis of the silent but ever dangerous problem.

There has been a push by the American Heart Association to provide screening for people at risk for AAA, including those with the family history. So far this type of screening has not been approved by Medicare despite some 60,000 deaths per year in the US alone. Once the AAA reaches the size of 5.0 cm to 5.5 cm in diameter, we usually recommend surgical resection or the implantation of a stent graft. The stent graft is a relatively new procedure. A stocking like device with stents on either end is attached to the aorta and the vessels below the aorta in a minimally surgical procedure. Patients usually leave the hospital the next day and the operative risk is low. Furthermore, the risk of male sexual dysfunction is less with stent graft treatment than with surgical resection. Nevertheless, there had been incidents of leaking of the stent grafts over time and they must be followed carefully by sonography or cat scanning.

Despite the newer and safer treatments for AAA, the challenge remains in identifying patients who have this problem and providing careful surveillance of their progression. It is my personal feeling that we have to find a way to provide sonography as a screening tool to those who are at risk, given the fact that sonography is cheap, totally safe to perform and without any pain what so ever. If you think you are at risk for this problem, you should visit with your physician about a possibility of an imaging test to rule it out.


 

 
Galichia Medical Group, P.A.
2600 N Woodlawn
· Wichita, KS 67220
1.316.684.3838
·
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