Aortic Aneurysm(AAA)

Aortic Aneurysm(AAA)

An aneurysm is a bulge in the artery wall weakened by atherosclerosis (hardening of the arteries), smoking, hypertension, or other causes Vessel walls balloon outward with the pressure of the blood flow inside. If an aneurysm bursts, it can cause heavy, life-threatening internal bleeding.

Aneurysms can form in arteries throughout the body, but most occur in the aorta. Starting in the heart and continuing through the chest and abdomen to the legs, the aorta is the body’s largest blood vessel.  If the aneurysm occurs in the lower section of the abdomen, it is known as an abdominal aortic aneurysm (AAA) lower portion of the chest, it is called a thoracic aortic aneurysm (TAA). Involves aorta of chest and abdomen, it is known as thoraco-abdominal aortic aneurysm(TAAA) Likewise name of the aneurysm varies depending upon the blood vessel it affects

Symptoms of Aortic Aneurysm

Aneurysms may expand slowly or quickly, or they may stay the same size for many years.

They often develop without any warning signs. 

Sometimes, however, people experience symptoms depending on the site –

Abdomen-aortic aneurysm(AAA)-

• Pulsing sensation in the abdomen 
• Abdomen pain
• Back pain
• Swelling of legs
• Sudden pain and loss of movement and sensation in both legs
• Gradual decrease in kidney function
• Symptoms of mesenteric disease 

Thoracic Aortic Aneurysm(TAA)/Thoraco Abdominal Aneurysm(TAAA)-

• Chest pain
• Neck pain
• Altered quality of voice
• Difficulty in breathing
• Sudden pain and loss of movement and sensation in both legs
• Gradual decrease in kidney function
• Symptoms of mesenteric disease

Treatment

Treatment for an aortic aneurysm depends on the size and severity of the condition, as well as the patient’s overall health. Medications are often prescribed as an initial treatment to help lower blood pressure, relax blood vessels reduce the risk of rupture. Correct  raised Cholesterol Aspirin (mild blood thinner) to reduce their risks of more Cardiovascular disease Many remain small and never rupture(smaller than the treatment cut-off size). These are kept on surveillance using a doppler ultrasound scan or sometimes a CT scan Large, fast-growing, leaking or painful aneurysms may require intervention. 70-80% with a leaking(ruptured) aneurysm will not survive.  Intervention options- Open surgery or Endovascular(minimally invasive) stent-grafting(EVAR/TEVAR)

Open Aneurysm Repair

Open aneurysm repair involves making an incision in the abdomen/chest, removing the section of the artery with the aneurysm, replacing the excised segment with a graft made of a synthetic tube and maintaining blood flow to important orangs. This procedure places the body under much greater stress than an endovascular approach However longterm outcomes are more successful with open repair

Aortic Endovascular stent Grafting (Evar/Fever)

In EVAR, a stent graft (a fabric covered wire frame in the shape of a tube) is implanted in the artery to provide a strong new vessel wall through two small groin cuts. The aneurysm generally shrinks around the stent as time passes.