An aneurysm is the abnormal widening of a blood vessel in a localized area.

The aorta transports blood from the heart through the center of the chest to the abdomen, legs and pelvis. It is also the largest blood vessel in the human body. The walls of the aorta can swell or bulge if they become weak. When this happens in part of the aorta that is in the abdominal area, it is known as Abdominal Aortic Aneurysm (AAA).

Although AAA does not always cause problems, a ruptured AAA can bleed, and this can be life threatening.

Types of Abdominal Aortic Aneurysms

AAAs are classified by the speed in which they are growing and their size as these are the factors that can help in predicting the health, and the health effects of the aneurysm.

Slow growing or small: Less than 5.5cm AAAs have a lower risk of rupturing than larger or fast-growing aneurysms. These are usually monitored with regular abdominal ultrasound.

Fast growing or large: Above 5.5cm – AAAs are more likely to rupture than the slow growing or small aneurysms. A rupture can lead to serious complications including internal bleeding. Large aneurysms should be treated if they are leaking blood or causing symptoms.

Causes of Abdominal Aortic Aneurysm

The exact cause of AAAs is not currently known but there are certain factors which play a role in increasing their risk. They include:

• Hypertension or high blood pressure: This can weaken the walls of the aorta increasing the risk of the formation of an aneurysm.
• Smoking: This can damage the walls of the walls of the arteries and make them more likely to bulge.
• Vasculitis or vascular inflammation: Serious inflammation within the arteries including the aorta can cause AAAs although this is very rare.
• Atherosclerosis: This is hardening of the arteries and it occurs when fatty deposits and other substances build up on the lining of the blood vessels, which can lead to inflammation of the said vessels.
• Trauma to the abdomen can lead to AAA.

Other risk factors include age, genetics, other aneurysms and being male.

Symptoms of Abdominal Aortic Aneurysm

Most AAAs often grow without showing any symptoms and this can make them difficult to detect. Although some aneurysms do not rupture, those that do rupture are accompanied by the following symptoms:

• Sudden pain in the back or abdomen
• Deep pain spreading from the back or abdomen spreading to the pelvis, buttocks or legs
• Clammy skin
• Pulse near the belly button
• Increased heart rate
• Loss of consciousness or shock

If you experience any of these symptoms, you should seek immediate medical attention as a ruptured aneurysm can be life threatening.

Diagnosis of Abdominal Aortic Aneurism

AAAs are often diagnosed during routine examination or scanning for other conditions. If your physician suspects that you might be having AAA, he/she will feel your stomach to see if it contains a pulsing mass or is rigid. Your medical and family history will also be reviewed in addition to performing the following tests to confirm diagnosis:

• Abdominal ultrasound
• Abdominal MRI
• CT scan for the abdomen
• Chest X-ray

Treatment of Abdominal Aortic Aneurism

Treatment for AAAs usually depend on their exact location, size and how fast they are growing. The treatment can be either medical-monitoring or surgery.

Medical monitoring is usually done on small or slow growing AAAs which are less than 5cm wide. Surgery can either be open abdominal surgery or endovascular surgery.

Open abdominal surgery is done if the aneurysm is large or has ruptured. It involves removing the damaged area of the aorta and replacing it with a graft (synthetic tube). Recovery from this surgery can take a month or more.

Endovascular surgery is less invasive than the open abdominal surgery and it involves placing a synthetic graft (a woven tube that is covered by a metal mesh support) at the site of the aneurysm. It is then expanded and fastened into place to stabilize the weakened area of the aorta. Recovery from endovascular surgery takes about two weeks.

Next Step

At King’s College Hospital Dubai, we focus on offering an exemplary service. From initial consultation through to final diagnosis, treatment and beyond. Our multidisciplinary team of expert doctors, nurses, cardiologists and technologists are here to offer tailored management and treatment of your condition, and to answer any questions that you may have throughout your time with us. Whatever you need us for, we’re only a phone-call away.