The aorta, the body’s largest artery, transports blood from the heart through the chest and abdomen. A weakened aortic wall can bulge, forming an aneurysm. When this occurs in the abdominal section, it’s called an abdominal aortic aneurysm (AAA). Over 200,000 people in the United States are diagnosed with abdominal aortic aneurysms annually, and approximately 15,000 die each year from a ruptured AAA. This high mortality rate highlights the importance of early detection.
What is an Abdominal Aortic Aneurysm?
AAA occurs when the wall of the abdominal aorta weakens, causing it to expand like a balloon. The aorta is the largest artery in the body and is responsible for carrying oxygen-rich blood from the heart to the rest of the body. Over time, the weakening of the aortic wall—often due to the breakdown of its structural proteins—creates a fragile bulge. If left untreated, this weakened area can rupture, leading to severe internal bleeding that can be life-threatening. Certain lifestyle choices, age, or medical conditions increase the risk of AAA.
Who Should Get Screened?
Men over 65 who have smoked are at the highest risk and qualify for a AAA and are eligible for Medicare-covered screening. However, other risk factors, such as a family history of aneurysms or other vascular diseases, may also warrant screening.
Risk Factors & Prevention
Risk factors for AAA include:
Many of the factors that increase the risk of an AAA are within your control, such as not smoking, maintaining a healthy blood pressure, and managing medical conditions such as heart disease. If you are at high risk, regular screening is painless and essential for preventing a rupture or other complications.
Diagnosing AAA
An aneurysm develops slowly over time and often has no symptoms. It is usually incidentally discovered during imaging, which is why screening is essential.
Symptoms of an abdominal aortic aneurysm will only appear if the condition becomes more severe. If the abdominal aorta expands too far, it can rupture and leak blood.
Abdominal aortic aneurysm symptoms include:
- Pain in the stomach or back that is severe, sudden, and constant
- Pain that spreads to the groin, legs, or buttocks
- Passing out
- Nausea and vomiting
- Rapid heart rate
- Dizziness
- Shock
A diagnosis of an abdominal aneurysm will typically start with a physical exam and questions about your medical history. During this exam, your provider will examine your abdominal area and feel the pulses in your legs. They look for a pulsatile mass in the abdomen, which could be a sign of an aneurysm.
If your doctor suspects you have an abdominal aneurysm, they will order an abdominal aortic ultrasound. This simple, quick, noninvasive test may reveal the exact size and location of the aneurysm, especially for people at high risk. Treatment will depend on the size and location of the aneurysm.
More advanced tests, like a CT scan and MRI, may be required for a complete diagnosis and are often included in the diagnostic workup. Once an aneurysm has been diagnosed, patients will be referred to a vascular doctor for further evaluation.
EVAR – The Gold Standard for AAA Treatment
Endovascular Aneurysm Repair (EVAR) is a minimally invasive stent procedure that reinforces the weakened aortic wall. This prevents rupture, with faster recovery than open surgery. At Empire Vein and Vascular Specialists, we prefer minimally invasive abdominal aortic aneurysm treatments whenever it’s an option versus open surgical repair.
Summary of the Procedure
EVAR involves two tiny incisions in the groin, and the insertion of a catheter. Under X-ray guidance, a covered stent is delivered through the catheter and placed inside the aneurysm. This stent fits snugly into the normal artery above and below the aneurysm so that it forms a new pathway for the blood to flow. This excludes the aneurysm sac, which then usually begins to shrink.
The procedure usually lasts less than two hours. Most patients are discharged within 24 hours, with a recovery time of approximately two weeks. Empire Vein and Vascular Specialists has performed 385+ EVAR procedures to date.
Why Choose Empire Vein and Vascular Specialists?
At Empire Vein and Vascular Specialists, our surgeons collectively have over 30 years of experience and have treated over 4,800 aneurysms. We have expertise in EVAR and accept most insurance plans.
FAQ & Next Steps
Most of the time, surgery is not needed for an abdominal aortic aneurysm. AAAs less than five cm can be safely monitored over time. If you do require surgery, it is rarely emergency surgery.
If your AAA doesn’t require surgery, your vascular surgeon will place you on a surveillance program, where they will perform a noninvasive ultrasound once or twice a year. Additionally, to slow down the progression of the aneurysm, you should quit smoking and monitor your blood pressure.
Aneurysms can grow silently for months to years with no symptoms. When they rupture, the patient can experience major blood loss, which can lead to death.
Quitting smoking is the most important thing one can do.
You want to look for a board-certified vascular surgeon, a doctor who has special training and experience in treating aneurysms with the latest minimally invasive techniques. Here at Empire Vein and Vascular Specialists, our surgeons collectively have over 30 years of experience and have treated over 4,800 aneurysms.
Schedule Your AAA Screening Today for early detection and expert care.