An Aneurysm is an abnormal widening or ballooning of a portion of an artery due to weakness in the wall of the blood vessel. The cause of an aneurysm is not exactly clear; some are present at birth (congenital) while others may be due to a defect in the wall of the blood vessel. High blood pressure and high cholesterol may raise your risk of certain types of aneurysms. Since blood vessels are elastic and are filled with blood under high pressure, the walls may become weakened by fatty deposit buildups called plaque (atherosclerosis). A ruptured aneurysm is extremely dangerous, causing life-threatening bleeding but fortunately, most aneurysms are discovered before they produce any symptoms. An aneurysm may form in any blood vessel, but they occur most commonly in the aorta.

Abdominal Aortic Aneurysm (AAA) is an enlargement of the lower part of the aorta that extends through the abdominal area. The aorta is the main blood vessel that carries blood from the heart to the rest of the body. An Abdominal Aortic Aneurysm is a major health risk that may or may not present symptoms. Most abdominal aneurysms are diagnosed during a routine physical exam or on x-rays when being tested for other concerns.

AAA symptoms include

• Pulsating enlargement or tender mass that may be felt in the abdomen
  
• Pain in the back, abdomen, or groin not relieved with position change or pain medication
  

AAA risk factors
Arteriosclerosis (atherosclerosis) occurs when the lining of the artery deteriorates thus walls become thickened and deposits of fat and plaque block the blood flow thru the artery

• High Blood Pressure
  
• High Cholesterol
  
• Diabetes
  
• Injury
  
• Infection
  
• Heredity
  
• Smoking
  
• Congenital Defects, such as inherited weakness in the blood vessel walls
  

AAA Screening
The Society for Vascular Surgery (SVS) recommends AAA screening for these patients:

• All men aged 60 to 85 years
  
• All women aged 60 to 85 years with cardiovascular risk factors
  
• All men and women aged 50 and older with a family history of AAA

AAA Testing
Once an aneurysm is suspected, the following tests may be used to determine the size, location and treatment options.

• Ultrasound
  
• CT Scan
  
• MRI
  
• Angiogram

AAA treatment
Abdominal Aneurysms over 5 cm or smaller symptomatic aneurysms require surgical treatment. There are two types of surgical treatments; open surgical repair and endovascular repair.

Open Surgical Repair - the surgeon makes an incision to access the abdominal aortic aneurysm. The diseased portion of the aorta is replaced with a synthetic graft that acts as a replacement blood vessel. Open surgical repair is a proven procedure with a good outcome and acceptable risks. It does involve a long recovery period, with a hospital stay of 5 to 8 days. Return to normal activity ranges from 6 weeks to 3 months. As with any operation, open surgical repair has a risk of complications that will be explained by your surgeon.

Endovascular Repair - a small fabric tube with metal stents attached inside (called a stent-graft) is introduced into your aorta and moved into place by the surgeon. First, small incisions are made in each groin to expose the arteries that carry blood from the aorta. The surgeon then moves the stent-graft up thru these arteries until it is opened inside the diseased portion of aorta. The stent-graft reinforces the weakened part of the aorta from the inside and creates a channel thru which the blood flows, eliminating the risk of rupture. The procedure usually takes 1 to 3 hours and patients typically leave the hospital within 1 to 2 days. Return to normal activity ranges from 2 to 6 weeks. Like any operation, the endovascular repair has a risk of complications that will be explained by your surgeon. It also involves regular routine follow-up visits with your surgeon, along with a CT scan to evaluate the stent-graft. These follow-up visits and scans are extremely important.

Observation - If your aneurysm is small; your doctor will recommend a follow-up visit to see him every 6 to 12 months, along with an ultrasound or CT scan. This follow-up is necessary in order to follow the size of the aneurysm and to review any symptoms that you may have.