Abdominal Aortic Aneurysm Surgery

Treatment depends on how quickly the aneurysm is growing

An abdominal aortic aneurysm is an enlarged area in the lower part of the aorta, the major blood vessel that supplies blood to the body. The aorta runs from your heart through the center of your chest and abdomen. Because the aorta is the body's main supplier of blood, a ruptured abdominal aortic aneurysm can cause life-threatening bleeding.

Depending on the size and rate at which your abdominal aortic aneurysm is growing, treatment may vary from watchful waiting to emergency surgery. Once an abdominal aortic aneurysm is found, doctors will closely monitor it so that surgery can be planned if it's necessary. Emergency surgery for a ruptured abdominal aortic aneurysm can be risky.

Symptoms and risk factors associated with abdominal aortic aneurysm

Abdominal aortic aneurysms often grow slowly and usually without symptoms, making them difficult to detect. Some aneurysms will never rupture. Many start small and stay small, although many expand over time. Others expand quickly. Predicting how fast an abdominal aortic aneurysm may enlarge is difficult.

As an aortic abdominal aneurysm enlarges, some people may notice:

  • A pulsating feeling near the navel
  • Deep, constant pain in your abdomen or on the side of your abdomen
  • Back pain

Abdominal aortic aneurysm risk factors include:

  • Age – Abdominal aortic aneurysms occur most often in people age 65 and older.
  • Tobacco use – Tobacco use is a strong risk factor for the development of an abdominal aortic aneurysm. The longer you've smoked or chewed tobacco, the greater your risk.
  • Atherosclerosis – The buildup of fat and other substances that can damage the lining of a blood vessel increases your risk of an aneurysm.
  • Being male – Men develop abdominal aortic aneurysms much more often than women do.
  • Family history – People who have a family history of abdominal aortic aneurysm are at increased risk of having the condition. People who have a family history of aneurysms tend to develop aneurysms at a younger age and are at higher risk of rupture.

Diagnosing and treating abdominal aortic aneurysm

Diagnosis is done by:

  • Abdominal ultrasound – This exam can help diagnose an abdominal aortic aneurysm.
  • Computerized tomography (CT) scan – This painless test can provide your doctor with clear images of your aorta.
  • Magnetic resonance imaging (MRI) – MRI is another painless imaging test.

Treatment options may include:

  • Open-abdominal surgery – Open-abdominal surgery to repair an abdominal aortic aneurysm involves removing the damaged section of the aorta and replacing it with a synthetic tube (graft), which is sewn into place, through an open-abdominal approach
  • Endovascular surgery – Endovascular surgery is a less invasive procedure sometimes used to repair an aneurysm. Doctors attach a synthetic graft to the end of a thin tube (catheter) that's inserted into an artery in your leg and threaded up into your aorta. The graft (a woven tube covered by a metal mesh support) is placed at the site of the aneurysm and fastened in place with small hooks or pins. The graft reinforces the weakened section of the aorta to prevent rupture of the aneurysm.

Recovery time for people who have endovascular surgery is shorter than for people who have open-abdominal surgery.

What to expect before, during and after aortic surgery