The aorta is the largest blood vessel (artery) in the body. It carries oxygenated blood from the heart to your arms, head, abdomen, pelvis and legs. It is shaped like a candy cane and is as thick as a garden hose and runs from the heart, down through the chest and abdomen. The wall of the aorta consists of 3 layers. The intima (innermost layer); the media and the adventitia (outer layer). The walls of the aorta can bulge out like a small balloon if it becomes weak. When this happens in the part of the aorta that’s in your abdomen, this is called an abdominal aortic aneurysm (AAA).
AAAs don’t always cause problems, but a ruptured aneurysm can be life-threatening. We ask one of our vascular surgeons, Mr JK. Wicks what you need to know.
- What is an abdominal aortic aneurysm? Put simply it is an enlarged or weakened area, in the lower part of the aorta.
- What is the difference between an aortic dissection and an AAA?
- An aortic dissection is a tear of the intima (inner most layer of the aorta), which allows blood to leak into the media (middle layer).
- An aortic aneurysm is a balloon-like bulge in your aorta.
Both conditions need urgent medical care.
- What do I do if I think I have an AAA? Speak with your GP if you are concerned about AAAs, have a family history of vascular disease or any other risk factors. Your GP can take a full history, send you for further tests and then refer you to a vascular specialist – either myself or Dr Lupe Taumeopeau.
- Symptoms: AAAs often grow slowly and very often there are no symptoms. An aneurysm may start small and stay small or expand quickly. Predicting how fast it may grow is difficult. Once diagnosed the patient will be put on a vascular ultrasound surveillance schedule. As an AAA enlarges some patients may notice the following
- A pulsating feeling near the navel
- A constant pain in the abdomen
- Back pain
- What are the causes of an AAA? The exact cause is unknown, but here are the following risks that may play a role:
- Atherosclerosis (plaque in arteries)
- High blood pressure
- Family history
- Age (over 65)
- Infection in the aorta
- Complications: Because the aorta is the body’s main supplier of blood, any weakness, bulge or rupture can cause a number of health problems and be life threatening.
- How is an AAA diagnosed? You GP or SVH surgeon will send you for an abdominal ultrasound. Sometimes your doctor will organise further tests such as a CT scan. If there is an aortic aneurysm, then there is a possibility that other arteries can also have an aneurysm, most commonly involving the leg artery behind the knee.
- Treatment: This depends on severity. The decision to treat an un-ruptured AAA depends upon its size, the risk to the patient to have an operation and the actual age of the patient.
- AAAs are grouped into 3 sizes – small, medium (3- 5cm in diameter) or large (larger than 5-5.5cm in diameter). The small to medium AAAs will be monitored with regular ultrasound scans. We advise lifestyle changes to stop it growing larger. Aneurysms that are too large or growing too quickly should be repaired with surgery. We offer 2 types of surgical treatment options.
- Open surgery: This is the more traditional treatment option. Open surgery is done to place a prosthetic graft over the affected portion of the aortic artery. Most patients stay in hospital for 4-10 days. Recovery at home can take up to 3 months
- Endovascular aneurysm repair (EVAR): This is a more modern technique and much less invasive. Small incisions are made. Guided by X-ray imaging, your surgeon will place a small expandable device (called a stent graft) into the artery. This procedure has surpassed open aortic surgery as the most common technique for AAA repair.
- Are there potential risks with AAA treatments? All surgical procedure can have complications – the benefits to your health out way the low risks. Your surgeon will discuss all potential risks with you prior to the procedure.
- What can I expect after the procedure?
- Treatment for AAAs is considered a major surgical procedure. Your surgeon will decide how many nights you should stay in hospital following your procedure.
- We advise you are to be driven home.
- At home, you should avoid heavy lifting, stooping, bending or strenuous exercise for 1-2 weeks to allow the wound site(s) to heal fully. Your surgeon and nurse will give you more specific instructions on discharge.
- An ultrasound will be organised for you within 2 weeks of your procedure by the staff at Specialist Vein Health. You will have ongoing ultrasound surveillance organised with our specialist vascular ultrasound lab.
- Follow up with your surgeon will be organised 2-4 weeks after the procedure.
Referrals are not always necessary. Contact us today.