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Early Detection of Abdominal Aortic Aneurysm Prevents Emergency Situation

William DiGilio, M.D., General Surgery, Columbia St. Mary’s

Posted: Feb. 1, 2007

Abdominal aortic aneurysm (AAA) is a fairly common problem that is caused by the weakening of the artery wall, caused by genetics and/or lifestyle. AAA commonly occurs just below the renal artery of the kidneys where it splits off to the legs. The degeneration weakens the wall of the abdominal aorta enough that the pressure inside forces it to balloon outward.

Abdominal aortic aneurysms can develop over time. Patients with this type of condition sometimes will have back or pelvic pain or cold, numb or tingling sensation in the feet due to blocked blood flow to the legs. But most patients have no symptoms at all, which is cause for concern because if the aneurysm ruptures, the result is a life-threatening situation. Sometimes, AAA is detected incidentally when patients undergo an X-ray, ultrasound or a CT scan for some other abdominal complaint. A mass may also be detected through a hands-on abdominal exam.

An ultrasound screening is suggested for people who are considered high risk. Patients at the greatest risk for AAA are usually older than 65 and have atherosclerosis (hardening of the arteries) or a connective tissue disorder. It tends to be more common in males. Smokers have a higher risk of occurrence. You should also be screened if anyone in your family has had an aneurysm.

With early detection, we can catch an abdominal aortic aneurysm before it becomes an emergency situation. If we detect an aneurysm that is smaller than 5.5 cm in diameter, we can monitor it with regular ultrasounds. If it’s over 5.5 cm in diameter, the risk of rupture increases and surgery may be necessary.

Symptoms of a ruptured AAA can be severe pain in the lower abdomen and back; nausea and vomiting; clammy, sweaty skin; lightheadedness and rapid heart rate. The internal bleeding from the rupture can cause shock, which is a life-threatening condition.

Treatment
Early detection of aneurysms yields the best results, and while surgery is still the gold standard for repair, it is considered major surgery with a lengthy recovery period. We’ve also had very good results with a less invasive procedure that inserts a replacement tube in the affected area.

Endovascular stent graft is performed through a smaller incision through the groin area. A Dacron- and metal-mesh stent is inserted in the area and inflated to expand and support the artery. As it embeds into the inner walls of the artery, it becomes anchored in place. As technology has advanced, these stents have become more adaptable and easier to work with.

Because this procedure is less invasive, both post-operative hospital stays and recovery periods are shorter. Post-surgical follow-ups require CT scans. It’s important to remember that not everyone is a good candidate for this type of surgery. Each patient must be evaluated to determine which procedure will yield the best surgical results. Early detection through ultrasound screenings allows us the time for careful evaluations, giving our patients the very best outcomes.

William DiGilio, M.D.
General Surgery
Columbia St. Mary’s
414-961-VASC

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