Dr Tom Maldonado: An aneurysm is an enlarged portion of a weak area of an artery. Over time, blood flow can cause the weak area to bulge like a balloon. An abdominal aortic aneurysm occurs in the abdominal section of the aorta, the main blood vessel that carries blood away from the heart.
Dr Tom Maldonado: Approximately 5 to 7 percent of adults over 60 are affected by abdominal aortic aneurysms. Although it appears to be twice as common in men than in women, the risk of rupture in women is actually fourfold that of men. When an abdominal aortic aneurysm ruptures, it carries a 75 to 90 percent mortality rate. Moreover, women appear to rupture at smaller size aneurysms and have worse outcomes than men with ruptured abdominal aortic aneurysm.
While only 2 to 3 percent of women appear to be affected by abdominal aortic aneurysm, age, smoking and heart disease are each associated with increased risk. When all three risk factors are present, the incidence of abdominal aortic aneurysm is as high as 7 percent. Smoking has been shown to be the single most important risk factor for women who develop abdominal aortic aneurysm. Other risk factors include hypertension, high cholesterol, obstructive pulmonary disease and family history.
There is a known genetic predisposition for abdominal aortic aneurysm formation. First-degree relatives are at increased risk. Anyone, male or female, with a sibling who has an abdominal aortic aneurysm has a fivefold risk.
People who are at risk need to be screened with a simple non-invasive ultrasound or sonogram. This should be done at age 60 in men and perhaps age 65 in women.
Dr Tom Maldonado: The vast majority of patients who have them have no symptoms at all. In fact, most abdominal aortic aneurysms are diagnosed as an incidental finding on an imaging study performed for some other reason. For instance, an ultrasound looking at the gall bladder or an MRI looking at the spine will pick up the abdominal aortic aneurysm. When patients become symptomatic they experience abdominal and/or back pain. This can be a sign of impending rupture and should be considered a medical emergency.
Dr. Tom Maldonado: The aorta normally measures approximately 2 centimeters in diameter. When an abdominal aortic aneurysm grows to greater than 5 centimeters, the risk of rupture becomes significant and warrants intervention. Traditionally, abdominal aortic aneurysm was repaired using an open operation where the aorta was replaced with a polyester tube. This necessitated a five- to seven-day hospital stay and had a significant recovery period. More recently, abdominal aortic aneurysm can be repaired in a minimally invasive manner.
Learn more about abdominal aortic aneurysms and Dr Tom Maldonado at http://www.med.nyu.edu/people/maldot01.html.
This 3D animation on abdominal aortic aneurysm surgery depicts the anatomy of the aorta and both the open and endovascular procedure for repairing an abdominal aortic aneurysm.
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