A Patient’s Guide to Abdominal Aortic Aneurysm (AAA)
By Bryan Kramer, MD and Taylor Caddell, RVU MSIII - December 30, 2019
What is an abdominal aortic aneurysm (AAA)?
What causes these and should I be worried about it?
- An aneurysm refers to an abnormal dilation of an artery. The rest of the AAA name refers to the location of the aneurysm, which in this case is in the abdominal portion of your aorta, which is a large artery that brings blood from your heart to the rest of your body.
How are these diagnosed and monitored?
- AAAs are caused when the pressure inside the artery overcomes the strength of the vessel wall, leading to widening of the vessel. This occurs for a variety of reasons and there are several things that increase your risk for AAAs, including older age, male gender, Caucasian race, family members with AAA, and smoking. SMOKING IS BY FAR THE BIGGEST RISK FACTOR FOR DEVELOPING AAA.
- The most serious complication of an AAA is rupture of the aorta. Because vessels can only stretch to a certain extent, the larger the diameter of the aneurysm, the larger the risk of this complication. For this reason, it is important to monitor the size of the aneurysm.
How do we manage this and is there anything I can do to slow the growth of the aneurysm?
- AAAs are often diagnosed incidentally during physical exams or abdominal scans for other medical reasons. The normal diameter of the abdominal aorta is less than 3cm in 95% of people, so an aneurysm is diagnosed when the size of the aorta becomes greater than 3cm. As discussed above, it is important to monitor the size of the aneurysm for signs of growth. This is usually done with yearly ultrasounds of the abdomen.
- These aneurysms tend to expand over time. At a certain point, the risk of rupture becomes greater than the risks associated with surgery. At that point, intervention is recommended, either with a minimally invasive stent or by open surgery to replace the aneurysm. Generally, intervention is considered when the AAA reaches 5cm in diameter.
- Until intervention is recommended, management of AAAs is focused on reducing factors that can accelerate growth of the aneurysm. Lowering high blood pressure and quitting cigarette smoking are two of the most important things that a person can do to limit growth of a AAA, with SMOKING CESSATION BEING MOST IMPORTANT.
- Lifetime follow-up with a vascular surgeon is important after AAA repair.