How Common is Abdominal Aorta Aneurysm Repair?

Abdominal aortic aneurysm repair has increased due to the introduction of screening guidelines and elective endovascular aneurysm repairs.

How do you get Abdominal Aorta Aneurysm Repair?

Abdominal Aortic Aneurysm Repair can be achieved through a surgical procedure known as elective endovascular aneurysm repair.

What else can Abdominal Aorta Aneurysm Repair be?

The doctor needs to rule out the following conditions when diagnosing Abdominal Aorta Aneurysm Repair: - Acute gastritis - Acute myocardial infarction - Acute urinary tract infection - Appendicitis - Cholelithiasis - Cystitis - Diverticulitis - Gastrointestinal bleed - Ischemic bowel - Large bowel obstruction - Nephrolithiasis - Musculoskeletal pain - Pancreatitis - Peptic ulcer disease - Perforated gastrointestinal ulcer - Pyelonephritis - Small bowel obstruction

What kinds of test are needed for Abdominal Aorta Aneurysm Repair?

The types of tests needed for Abdominal Aortic Aneurysm (AAA) repair include: - One-time abdominal ultrasound for screening, recommended for individuals aged 65 or older who have a history of smoking or a family history of AAAs. - Follow-up ultrasounds every year if the aneurysm size is between 3.5 cm to 4.4 cm. - Follow-up ultrasounds every 6 months if the aneurysm size is between 4.5 cm to 5.4 cm. - High-quality CT angiography with computerized reconstruction is recommended if the aneurysm is in need of repair. For emergencies or aneurysms involving the kidney arteries, open surgical repair may be necessary. Other endovascular methods like fenestrated and branched grafts could be alternatives for aneurysms involving the kidney arteries.

How is Abdominal Aorta Aneurysm Repair treated?

Abdominal Aorta Aneurysm Repair can be treated through two proven methods: endovascular surgery and open surgery. Endovascular aneurysm repair (EVAR) is often the first choice, but it requires specific body structure criteria. Open surgical repair is generally used for emergencies and cases where the patient's body structure isn't suitable for endovascular repair. Other endovascular methods may be used for aneurysms involving the kidney arteries.

What are the side effects when treating Abdominal Aorta Aneurysm Repair?

The potential side effects when treating Abdominal Aorta Aneurysm Repair include: - Kidney failure - Stroke - Heart attack - Reduced blood supply to the legs - Bleeding - Infection of an implanted graft - Damage to the tubes that carry urine from the kidneys to the bladder (ureters) - Erectile dysfunction - Reduced blood supply to the intestines - Blood clot in a deep vein (deep vein thrombosis)

Abdominal Aorta Aneurysm Repair

What is Abdominal Aorta Aneurysm Repair?

An abdominal aortic aneurysm, or AAA, is a condition that often requires surgery due to the high risk of death (around 78%) if it bursts. There are two methods surgeons can use to fix an AAA: open surgery and endovascular surgery.

In open surgery, the surgeon gets to the aorta, which is the large blood vessel running through the abdomen, through either the front of the abdomen or the back, and puts a clamp on it to stop the blood flow. The surgeon then opens the aneurysm sac (the swollen part of the aorta) and places a graft (a surgical patch) inside, which is then sewn into the aorta. This helps to exclude the swollen portion of the blood vessel. After this, the sac is closed over the graft.

In endovascular surgery, the process is a bit different. The surgeon gets to the aorta through the femoral artery in the leg – this can be done either through a surgical cut or a less invasive method called percutaneous access. The graft is then placed over a wire and pushed upwards (retrograde) to the affected part of the aorta. This is done using fluoroscopic imaging, which provides a live X-ray image to guide the surgeon. The graft is then expanded to fit the aorta.

Reasons for choosing to repair an AAA include when the aneurysm is large (5 cm in women, 5.5 cm in men), expanding quickly, causing symptoms, or has burst.

What Causes Abdominal Aorta Aneurysm Repair?

The length of time a person has been smoking is the most significant risk factor in developing AAA, or Abdominal Aortic Aneurysm. The risk of developing AAA also increases with age (specifically for men over 50 and women over 60), for men, for white individuals, and for those with a family history of AAA. Other related factors include vasculitides (a group of conditions causing inflammation in blood vessels), infectious aortitis (inflammation of the aorta), a variation in the LRP1 protein (related to low-density lipoprotein receptor), and, in rare instances, Marfan syndrome.

Certain conditions are specifically linked with a higher risk of AAA rupture. These include having an AAA larger than 6 cm, being female, currently smoking, having uncontrolled high blood pressure, severe chronic obstructive pulmonary disease (a type of lung disease), AAA growing more than 0.5 cm per year, and having multiple family members with AAA.

Risk Factors and Frequency for Abdominal Aorta Aneurysm Repair

Since the early 2000s, there has been a noticeable decrease in the cases of AAA (abdominal aortic aneurysm), its rupture rates, and the number of deaths related to AAA compared to figures from the 1990s. This condition was once found in between 4% to 9% of men, but recent research shows that the number has fallen to less than 2%. Several factors contribute to this improvement:

A significant drop in smoking rates, as it causes 75% of AAA cases.
The introduction of screening guidelines, which helps to reduce the number of deaths due to AAA by approximately 40%.
An increase in a surgical procedure known as elective endovascular aneurysm repairs which help to correct AAA.

Signs and Symptoms of Abdominal Aorta Aneurysm Repair

Abdominal Aortic Aneurysm (AAA) is a condition that can be evaluated through feeling the abdomen and checking the pulses in the thigh and behind the knee. However, physical checks can miss as much as 25% of AAAs that are larger than 5 cm. Some patients might feel a strong pulse or a throbbing mass in their abdomen. Other signs can include symptoms caused by a blood clot from the aneurysm wall, like in blue toe syndrome, or symptoms similar to deep vein thrombosis, due to the aneurysm pressing on large veins. Other less common symptoms can include chronic back pain if it’s affecting the spine, feeling full quickly and feeling sick from blockage of the stomach exit, or inability to urinate due to blockage of the urine tube. If the AAA ruptures, it usually causes severe back or abdominal pain, low blood pressure and a throbbing abdominal mass. However, this classic trio of symptoms only appears in half of the cases.

Feeling a strong pulse or throbbing mass in the abdomen
Symptoms of blue toe syndrome or deep vein thrombosis
Chronic back pain if the spine is affected
Feeling full quickly and nausea from blockage of the stomach exit
Inability to urinate due to blockage of the urine tube
Severe back or abdominal pain, low blood pressure, and a throbbing abdominal mass if AAA ruptures

Testing for Abdominal Aorta Aneurysm Repair

If you’re 65 or older and have either been a smoker or have a family history of Abdominal Aortic Aneurysms (AAAs), it’s recommended that you have a one-time abdominal ultrasound to screen for this condition. Men with a family history of AAAs can start this screening as young as 55 years old. If the aneurysm is between 3.5 cm to 4.4 cm, a follow-up ultrasound every year is advised. If the aneurysm’s size is between 4.5 cm to 5.4 cm, an ultrasound check-up every 6 months is recommended. If the aneurysm is in need of repair, a high-quality CT angiography (a type of X-ray that can produce in-depth images of the blood vessels) with computerized reconstruction is the suggested approach.

Treatment Options for Abdominal Aorta Aneurysm Repair

There are two proven treatment methods for repairing aneurysms in the aorta, the main artery in the body. These are endovascular surgery and open surgery. Endovascular aneurysm repair (EVAR) is often the first choice for either planned or emergency surgery. However, this technique requires the patient to have a specific body structure, which includes the presence of an aneurysm neck between 1.0 cm to 1.5 cm, a neck diameter under 3.2 cm, aortic angulation under 60 degrees, and blood vessels that are suitable for the delivery of the endograft.

Open surgical repair is generally used for emergencies like ruptured aneurysms and for aneurysms that are very close to or involving the kidney arteries. It’s also used in cases where the patient’s body structure isn’t suitable for endovascular repair.

For aneurysms that involve the kidney arteries, other endovascular methods featuring fenestrated and branched grafts could be alternatives.

Acute gastritis (sudden inflammation or swelling in the stomach lining)
Acute myocardial infarction (heart attack)
Acute urinary tract infection (an infection in any part of the urinary system)
Appendicitis (inflammation of the appendix)
Cholelithiasis (gallstones)
Cystitis (inflammation of the bladder)
Diverticulitis (inflammation or infection in one or more small pouches in the digestive tract)
Gastrointestinal bleed (bleeding in the digestive system)
Ischemic bowel (insufficient blood flow to the intestines)
Large bowel obstruction (blockage in the large intestine)
Nephrolithiasis (kidney stones)
Musculoskeletal pain (pain in the muscles or skeleton)
Pancreatitis (inflammation of the pancreas)
Peptic ulcer disease (sores that develop on the lining of your stomach, upper small intestine, or esophagus)
Perforated gastrointestinal ulcer (a hole that forms in the wall of the stomach, small intestine, or large bowel)
Pyelonephritis (kidney infection)
Small bowel obstruction (blockage in the small intestine)

What to expect with Abdominal Aorta Aneurysm Repair

The mortality rate is quite low for planned repair surgery of Abdominal Aortic Aneurysm (AAA). However, in cases where the aneurysm has already ruptured, the risk of death can be higher than 50%. Additionally, even those who make it through surgery aren’t out of the woods and might experience complications such as issues with wound healing, intestinal tissue damage due to lack of blood supply, heart failure, death of leg tissue, and failure of multiple organs.