An aneurysm is a bulge or weakness in a blood vessel. When this happens in the aorta (one of main blood vessels in the body), it’s called an aortic aneurysm. Small aortic aneurysms don’t need to be treated, but larger ones will need surgery in case they burst. Show
The aorta is a blood vessel about the thickness of a garden hose that carries blood from the heart through the centre of the chest and into the abdomen. Aortic aneurysms can happen anywhere along the length of the aorta, but they are most common in the lower part. This is called an abdominal aortic aneurysm. When they happen in the upper part of the aorta, in the chest, it is called a thoracic aortic aneurysm. The bulge in the aorta happens when part of the blood vessel grows weak and expands under pressure. Aneurysms usually start small and then grow bigger as the pressure increases. They usually grow very slowly. Sometimes aneurysms burst and cause bleeding inside the body. Because the aorta is such a large blood vessel, this can be very dangerous and is often fatal. Aortic aneurisms greater than 5.5cm usually require surgery to reduce the risk of ruptureAortic aneurysm symptomsAortic aneurysms usually don't have any symptoms until they burst. Signs of a possible aortic aneurysm in the chest include:
If the aneurysm is in the abdomen, signs can include:
Aortic aneurysm diagnosisThere is no screening in Australia for aortic aneurysms. Often they are found when people see their doctor for something else, such as prostate problems or gallstones. Your doctor might suggest you have an ultrasound scan if you are at high risk of an aortic aneurysm, for example if you are a man aged over 60, a smoker, have high blood pressure, have hardening of the arteries, or if you have a brother or father who had had an aortic aneurysm. Most people with an aortic aneurysm will have a CT scan or MRI scan so the doctor can look at it in more detail. Aortic aneurysm treatmentSmall aneurysms less than 5.5 cm across usually do not need treatment. You will need to see your doctor and have ultrasound scans regularly to keep an eye on the aneurysm. Aneurysms larger than 5.5 cm across will probably need surgery because they are more likely to burst. You might also need surgery if the aneurysm is smaller but growing quickly or causing other problems. Until recently, the only treatment for an aortic aneurysm was open surgery, a major operation that replaces the faulty part of the aorta with an artificial blood vessel. Patients usually stay in hospital for 7 to 10 days and will spend some time in intensive care. Some people may be able to have a stent inserted into the aneurysm through small cuts in the groin to strengthen the wall of the aorta. This is called endovascular surgery. It is not suitable for all types of aortic aneurysm. Another possibility is to repair the aortic aneurysm via keyhole surgery. You may also be given medicines to lower the risk of the aneurysm bursting. Aortic aneurysm preventionIt is not possible to prevent an aortic aneurysm, but it is possible to stop it from growing. If you have an aortic aneurysm, you should stop smoking and follow your doctor’s advice for keeping your blood pressure down and treating hardening of the arteries. When to seek helpIf you have an aortic aneurysm that bursts, you need to go straight to hospital. Symptoms of a burst aortic aneurysm include:
Where to seek more informationThe Australian and New Zealand Society for Vascular Surgery provides patient information on aortic aneurysm. If you want help quitting smoking, call the Quitline on 13 7848.
An aneurysm is a weak section of an artery wall. Pressure from inside the artery causes the weakened area to bulge out beyond the normal width of the blood vessel. An abdominal aortic aneurysm is an aneurysm in the lower part of the aorta, the large artery that runs through the torso.
What is an abdominal aortic aneurysm?The aorta is the largest blood vessel in the body. It delivers oxygenated blood from the heart to the rest of the body. An aortic aneurysm is a bulging, weakened area in the wall of the aorta. Over time, the blood vessel balloons and is at risk for bursting (rupture) or separating (dissection). This can cause life threatening bleeding and potentially death. Aneurysms occur most often in the portion of the aorta that runs through the abdomen (abdominal aortic aneurysm). An abdominal aortic aneurysm is also called AAA or triple A. A thoracic aortic aneurysm refers to the part of the aorta that runs through the chest. Once formed, an aneurysm will gradually increase in size and get progressively weaker. Treatment for an abdominal aneurysm may include surgical repair or removal of the aneurysm, or inserting a metal mesh coil (stent) to support the blood vessel and prevent rupture. Abdominal Aortic Aneurysm ShapesThe more common shape is fusiform, which balloons out on all sides of the aorta. A bulging artery isn’t classified as a true aneurysm until it increases the artery’s width by 50 percent. A saccular shape is a bulge in just one spot on the aorta. Sometimes this is called a pseudoaneurysm. It usually means the inner layer of the artery wall is torn, which can be caused by an injury or ulcer in the artery. What causes an abdominal aortic aneurysm to form?Many things can cause the breakdown of the aortic wall tissues and lead to an abdominal aortic aneurysm. The exact cause isn't fully known. But, atherosclerosis is thought to play an important role. Atherosclerosis is a buildup of plaque, which is a deposit of fatty substances, cholesterol, cellular waste products, calcium, and fibrin in the inner lining of an artery. Risk factors for atherosclerosis include:
Other diseases that may cause an abdominal aneurysm include:
What are the symptoms of abdominal aortic aneurysms?About 3 out of 4 abdominal aortic aneurysms don't cause symptoms. An aneurysm may be found by X-ray, computed tomography (CT or CAT) scan, or magnetic resonance imaging (MRI) that was done for other reasons. Since abdominal aneurysm may not have symptoms, it's called the "silent killer" because it may rupture before being diagnosed. Pain is the most common symptom of an abdominal aortic aneurysm. The pain associated with an abdominal aortic aneurysm may be located in the abdomen, chest, lower back, or groin area. The pain may be severe or dull. Sudden, severe pain in the back or abdomen may mean the aneurysm is about to rupture. This is a life-threatening medical emergency. Abdominal aortic aneurysms may also cause a pulsing sensation, similar to a heartbeat, in the abdomen. The symptoms of an abdominal aortic aneurysm may look like other medical conditions or problems. Always see your doctor for a diagnosis. How are aneurysms diagnosed?Your doctor will do a complete medical history and physical exam. Other possible tests include:
What is the treatment for abdominal aortic aneurysms?Treatment may include:
A small aneurysm or one that doesn't cause symptoms may not require surgery until it reaches a certain size or is rapidly increasing in size over a short period of time. Your doctor may recommend "watchful waiting." This may include an ultrasound, duplex scan, or CT scan every 6 months to closely monitor the aneurysm, and blood pressure medicine may be used to control high blood pressure. If the aneurysm is causing symptoms or is large, your doctor may recommend surgery. SurgerySurgery may be necessary if the aneurysm is large or fast growing, increasing chances of rupture. Women with large aneurysms are more likely than men to suffer a rupture. For suprarenal (above the kidneys) AAA, only open surgery is available in the U.S. right now, though Johns Hopkins vascular surgeons are involved in endovascular device trials that may be a suitable option. However, AAA at or below the kidneys may be treated by open or endovascular surgery. Endovascular means “within the blood vessel” and is considered minimally invasive. Not all patients can tolerate the risk of open surgery, so endovascular repair is a great option. Unfortunately, not all patients have the anatomy to qualify for endovascular repair. Consult your vascular surgeon about which technique is best for you.
What is aortic dissection?An aortic dissection starts with a tear in the inner layer of the aortic wall of the thoracic aorta. The aortic wall is made up of 3 layers of tissue. When a tear occurs in the innermost layer of the aortic wall, blood is then channeled into the wall of the aorta separating the layers of tissues. This generates a weakening in the aortic wall with a potential for rupture. Aortic dissection can be a life-threatening emergency. The most commonly reported symptom of an aortic dissection is sudden, severe, constant chest or upper back pain, sometimes described as "ripping" or "tearing." The pain may move from one place to another. When a diagnosis of aortic dissection is confirmed, immediate surgery or stenting is usually done. What causes aortic dissection?The cause of aortic dissection is unclear. However, several risk factors associated with aortic dissection include:
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