Abdominal Aortic Aneurysms

What is an abdominal aortic aneurysm (AAA)?

An abdominal aortic aneurysm (AAA) is a bulging or swelling in the lower part of the aorta, the major blood vessel that supplies blood to the body. When the walls of the aorta weaken, they can expand, forming an aneurysm. If left untreated, an AAA can grow larger and potentially rupture, leading to life-threatening internal bleeding.

AAAs are most commonly found in older adults and may not always present symptoms, making early detection through screening crucial.

Symptoms

In many cases, an abdominal aortic aneurysm develops slowly and does not cause noticeable symptoms. However, when symptoms do occur, they may include:

  • A pulsating sensation in the abdomen

  • Deep, persistent pain in the abdomen or lower back

  • Unexplained back pain

  • A feeling of abdominal fullness or discomfort

If an AAA ruptures, it can cause sudden and severe symptoms, such as:

  • Intense abdominal or back pain

  • Dizziness or fainting

  • Rapid heart rate

  • Severe drop in blood pressure (shock)

A ruptured aneurysm is a medical emergency that requires immediate attention.

Risk Factors

Several factors increase the risk of developing an abdominal aortic aneurysm, including:

  • Age – Most common in people over 65

  • Gender – Men are more likely to develop AAAs than women

  • Family History – A history of aneurysms in close relatives increases risk

  • Smoking – A major risk factor that weakens artery walls

  • High Blood Pressure (Hypertension) – Increases stress on the aortic walls

  • Atherosclerosis – Plaque buildup in the arteries contributes to aneurysm formation

  • Obesity – Can contribute to high blood pressure and vascular issues

Screening

Early detection of an AAA can be lifesaving. Screening is recommended for individuals at higher risk, particularly:

  • Men aged 65 to 75 who have ever smoked

  • Individuals with a family history of AAA

  • Those with cardiovascular risk factors such as high blood pressure or atherosclerosis

Screening is typically performed using an ultrasound, which is a quick, painless, and non-invasive procedure that can accurately detect an aneurysm.

Management

The management of an abdominal aortic aneurysm depends on its size, growth rate, and associated symptoms.

Monitoring

For small aneurysms (less than 5 cm in diameter), doctors may recommend regular monitoring through:

  • Periodic ultrasound or CT scans to track growth

  • Lifestyle modifications such as smoking cessation, healthy diet, and exercise

  • Controlling blood pressure and cholesterol with medications

Surgical Intervention

If an aneurysm is large (greater than 5.5 cm) or rapidly growing, surgery may be necessary. Treatment options include:

  • Endovascular Aneurysm Repair (EVAR) – A minimally invasive procedure using a stent graft to reinforce the weakened aorta

  • Open Surgical Repair – A more invasive procedure where the weakened portion of the aorta is replaced with a synthetic graft

Both procedures aim to prevent rupture and improve patient outcomes.

Conclusion

Abdominal aortic aneurysms can be life-threatening if not detected early. Understanding the risk factors, undergoing appropriate screening, and following recommended management strategies can help reduce complications. If you are at risk or have concerns about AAA, consult your healthcare provider for guidance.