Abdominal Aortic Aneurysm and Treatment
Ruptured abdominal aortic aneurysm is the 10th leading cause of death in adults in the United States. Approximately 15,000 Americans die each year from this disease.
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The aorta is the largest artery in the body and carries the blood that is pumped out of the heart to other organs. The aorta extends from the heart, down through the chest (thoracic aorta) and into the abdomen (abdominal aorta).
An aneurysm is a swelling or weakened area in a blood vessel. Weakening of the aorta can result in an aneurysm (enlarged or ballooning aorta), a dissection (tear within the inner wall of the aorta), or a rupture of the aorta. Aneurysms can affect virtually any artery in the body and frequently occur in the abdominal aorta.
Risk Factors
A variety of factors may contribute to the development of an abdominal aortic aneurysm including:
- Family history
- High blood pressure
- History of aneurysms in other locations in the body
- Increasing age
- Male gender
- Smoking
Symptoms
Abdominal aortic aneurysms develop slowly and are typically without symptoms (asymptomatic); however, if symptoms are present, they may include:
- Discoloration of toe (rate)
- Pain in leg or toe (rare)
- Pulsating mass in your abdomen, similar to a heartbeat
- Severe, sudden pain in your abdomen, lower back, or scrotum
Diagnosis
Diagnosis of abdominal aortic aneurysm is made using the following tests:
Treatment
Medical Therapy
Once diagnosis of an abdominal aortic aneurysm is confirmed, and surgery is either currently unnecessary or is not an option, medical management and serial (routinely repeated) testing is required to minimize the growth and monitor the aneurysm. Serial testing is usually completed every 6 months to 1 year depending on each individual case. Medical therapy may include:
- Lifestyle Modification (Risk Reduction)
- Medication to control cholesterol
- Medications to minimize the growth rate of the aneurysm by slowing the heart rate, reducing the heart's force of contraction and lowering the blood pressure
Surgery
The decision to treat an unruptured abdominal aortic aneurysm with vascular surgery depends on the size of the aneurysm. There are two surgical options or approaches to repair an aortic aneurysm: traditional open surgery repair and the minimally-invasive endovascular repair. The decision regarding the surgical approach is generally based upon the patient's anatomy, cardiovascular health and a discussion between the patient and the surgeon.
Open Surgery
Abdominal aortic aneurysm open repair is the surgical repair of an aortic aneurysm. A tube called an aortic graft, made out of synthetic (man-made) material, is placed in the diseased aorta to allow blood to pass safely through the aneurysm, preventing rupture of the aorta. AAA repair is performed through an incision in the abdomen.
Minimally-Invasive Endovascular Therapy: Stent Graft Repair
Endovascular repair is a procedure in which a catheter is inserted into an artery in the groin to repair an aortic aneurysm. The catheter contains a tube called an endovascular stent graft made out of synthetic (man-made) material. The catheter is advanced and placed inside the aneurysm with the use of special endovascular instruments and x-ray images. Once in place, the endovascular stent graft is expanded to fit snugly in place. The endovascular stent graft allows blood to pass safely through the aneurysm, preventing rupture of the aorta.
Because endovascular repair is usually performed through the groin via the femoral artery, it is important that the size of a patient’s femoral artery is large enough to accommodate a catheter. Women may have femoral arteries that are too small for this technique.
Because these catheter-based procedures are considered minimally invasive, patients experience the following benefits:
- Faster return to normal daily activities
- Improved clinical outcomes
- Less blood loss
- Less pain
- Shorter recovery time
- Smaller incisions with less scarring
Outcomes
At the Bluhm Cardiovascular Institute, we evaluate our clinical outcomes clinical outcomes so that we can fully understand how our treatments and procedures benefit our patients. We regularly review and evaluate our clinical outcomes and, based on the results, develop methods to monitor and improve the healthcare we offer to our vascular patients.
Patient Stories
Individuals from across the country travel to the Bluhm Cardiovascular Institute to receive exceptional patient care and the most advanced treatments available. Meet our patients who were successfully treated for abdominal aortic aneurysms.
Clinical Trials
Ongoing clinical research trials at the Center for Vascular Disease are investigating new treatments options for abdominal aortic aneurysms to ensure that our patients continue to receive the most innovative care in the country. For more information regarding these clinical trials, visit the Clinical Trials Unit of Northwestern, send an email or call 312-926-4000.
Contact Us Today
For more information regarding abdominal aortic aneurysms and the treatments available, please contact the Bluhm Cardiovascular Institute at 866-662-8467. To schedule an appointment, please call 312-695-4965 or request a first-time appointment online.