Abdominal Aortic Aneurysm (AAA)

What is an abdominal aortic aneurysm (AAA)?
The main blood vessel in your body is the aorta. It is a long blood vessel that reaches from your chest into your abdomen. It carries blood from your heart to the rest of your body. The part of the aorta in your abdomen is called the abdominal aorta. It supplies blood to your stomach, pelvis, and legs.

Sometimes an area of a blood vessel wall will get weak. It can start to swell like a balloon and become abnormally large. This is called an aneurysm. If an aneurysm forms in your abdominal aorta and grows too large, your aorta could tear or burst.

Symptoms of an AAA
As the aneurysm develops, there are usually no symptoms. This can go on slowly for years. Often, AAAs don’t cause symptoms unless they leak, tear, or rupture. If this happens, you may experience:

sudden pain in your abdomen, groin, back, legs, or buttocks
nausea and vomiting
abnormal stiffness in your abdominal muscles
problems with urination or bowel movements
clammy, sweaty skin.
If you have these symptoms, call your doctor. Internal bleeding from a ruptured AAA can put you into shock. Shock can be fatal if not treated right away.

What causes an AAA?
Doctors don’t know exactly what causes an AAA. Weaker aorta walls increase your chance of developing an aneurysm. There are many conditions that can weaken the walls of the aorta. These include aging, smoking, and high blood pressure. If any of the following factors apply to you, you are at higher risk of having an AAA.

Being male. Men are more likely than women to develop an AAA.
Age. AAAs are more common in people age 65 or older.
Personal history. If you have had aneurysms of any kind, you are at greater risk of an AAA.
Smoking. Smoking damages and weakens the aorta walls.
High blood pressure. Having high blood pressure weakens the walls of your aorta.
Family history. If any family members have had AAAs, you are at higher risk. You also could get an AAA before you are 65.
Talk to your doctor if you have a higher risk for an AAA, or if you have any of the symptoms.

How is an AAA diagnosed?
Doctors commonly find AAAs by chance during a routine exam. They also find them when doing tests for other issues, including unrelated pain in your abdomen. Doctors recommend an AAA screening for men age 65 to 75 who have ever smoked.

If your doctor finds or thinks you have an AAA, he or she may order tests. Common tests include:

Ultrasound or echocardiogram – These use sound waves to create pictures of the inside of your body.

Computed tomography (CT) scan – The doctor uses X-rays to take pictures of your organs. Dye is injected into your veins so he or she can see them clearly.

Magnetic resonance imaging (MRI) – This test uses magnets and radio waves to create pictures of your organs.

Angiography – This test uses dye and X-rays to look at the inside of your arteries. This can help your doctor see how much damage or blockage there is in your blood vessels.

If your doctor finds or thinks you might have an AAA, he or she might refer to you a specialist for treatment.

Can an AAA be prevented or avoided?
You can’t always prevent an AAA from forming. But there are steps you can take to lower your risk. These include:

Don’t smoke, or try to quit, if you are a smoker.
Eat a healthy diet.
Be physically active.
Manage conditions such as high blood pressure that can be controlled with medicine.
AAA treatment
Treatment for an AAA depends on its size. If your aneurysm is small, it might not need to be treated. Your doctor may just monitor it using routine testing. If your doctor is concerned about it, he or she may prescribe medicine. These can be used to lower blood pressure or relax blood vessels. This can help prevent the AAA from rupturing.

If your aneurysm is large or is growing quickly, you will most likely need surgery. There are 2 main kinds of surgery to remove or repair AAAs:

Open abdominal surgery – This is the most common form of surgery for an AAA. The surgeon will make an incision (cut) in your abdomen. He or she will remove the aneurysm. The removed section of the aorta is replaced with a graft made of man-made material.

Endovascular repair – In this procedure, the doctor inserts a graft into the aorta to strengthen it. He or she will insert a catheter (tube) into your artery through your leg. The graft will be threaded through the aneurysm and expanded. This will reinforce the weak section of the aorta and allow blood to flow normally. This helps keep the AAA from rupturing.

The type of surgery you have depends on many factors. Talk to your doctor about which kind is best for you.

Living with an AAA
If you have an AAA, it is important to get regular medical care. Listen to your doctor and follow your treatment plan. He or she may advise you to avoid lifting heavy objects. Try to avoid highly emotional situations or crises that could raise your blood pressure. Take care of yourself to prevent the aneurysm from bursting or tearing.

Questions to ask your doctor
If I’ve had one AAA, am I likely to experience another?
Are there any lifestyle changes I can make to avoid getting another AAA?
Is watchful waiting safe? Is there a chance the AAA could burst?
Are there any side effects from an AAA that I should be watching for?
What should I do if my pain gets worse?
Should I visit a specialist?
Are there any websites you recommend where I can learn more about AAAs?
Resources
National Heart, Lung, and Blood Institute, Aneurysm

U.S. National Library of Medicine, Aortic Aneurysm