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<h1> Abdominal Aortic Aneurysm</h1> <p>An abdominal aortic aneurysm is a dilation (ballooning) of segment of the aorta that is located in the abdomen. An abdominal aortic aneurysm in most cases leads to no warning signs until it ruptures (bursts). A ruptured abdominal aortic aneurysm is usually lethal. An abdominal aortic aneurysm less than 50 mm broad has a below average risk of rupture. A surgery to repair the aneurysm will be advised if it is larger sized than 50 mm, as previously mentioned this dimension the danger of rupture grows. Men 65 years old and more are to be proposed a program scan to screen for abdominal aortic aneurysm.</p> <h2>What is the aorta?</h2><p>The aorta is the largest artery (blood vessel) in the body. It carries blood from the heart and descends through the chest and the abdomen. Many arteries come off the aorta to supply blood to all parts of the body. At about the level of the pelvis the aorta divides into two arteries, one going to each leg.</p> <h2 >What is an aneurysm and an abdominal aortic aneurysm?</h2><p>An aneurysm is where a area of an artery widens (balloons out). The wall of an aneurysm is vulnerable than a healthy artery wall. The tension of the blood inside the artery results in the weaker section of wall to balloon.<br /><br /><div style="text-align:center<img style="width:294px;height:270px;float:left;" src="http://www.abdominalaneurysm.net/wp-content/uploads/2012/03/AAA.gif" alt="Abdominal Aortic Aneurysm"/> <img style="width:310px;height:263px;" src="http://www.abdominalaneurysm.net/wp-content/uploads/2012/03/abdominal-aortic-aneurysm.gif" alt="Diagram showing the main arteries of the body and details of an aortic aneurysm"/></div><br /><br />Aneurysms could happen in any existing artery, but they most generally occur in the aorta. Most aortic aneurysms occur in the area of the aorta that goes through the abdomen. These are recognized as abdominal aortic aneurysms (AAAs). In some cases they occur in the section heading via the chest. These are known as thoracic aortic aneurysms.<br /><br />The regular size of the aorta in the abdomen is about 20 mm. An [http://www.abdominalaneurysm.net abdominal aortic aneurysm] is said to be present if a area of the aorta within the abdomen is 30 mm or more in diameter.<br /><br />The rest of this booklet is only about AAAs.<br /><br />AAAs vary in sizing. As a rule, at the time you strengthen an AAA, it tends progressively to get greater. The speed at which it obtains larger differs from person to person. In spite of this, on average, an AAA tends to get larger by about 10% every year.</p> <h2>What causes an abdominal aortic aneurysm?</h2> <h3>In most cases</h3><p>The actual reason why an aneurysm figures in the aorta in most cases is not well-defined. Most instances happen in older people. An AAA is uncommon in people below the age of 60. For that reason, getting old has a significant role to play.<br /><br />The wall of the aorta normally has levels of easy muscles, and layers made from tissues termed elastin and collagen. Elastin and collagen are powerful boosting tissues. What seems to happen is that a part of the aorta loses its standard strength and flexibility in some people as they become older. Researches advises that this is due to changes in the elastin, collagen and smooth muscle tissues. There seem to be difficult biochemical procedures that trigger these transformations. Some people are more susceptible than others to these changes.<br /><br />Your hereditary make-up performs a part, as you have a considerably higher chance of developing an AAA if one of your parents has, or had, one.<br /><br />Atheroma could as well play a part. Atheroma is a fatty material that deposits within the inside of lining of arteries. Atheroma is sometimes termed furring of the arteries. Most AAAs are lined with some atheroma. Any individual can develop atheroma, but it develops more usually with growing age. Several risk factors also enhance the chance of atheroma forming. They include: smoking, high blood tension, diabetes, raised cholesterol level, taking little exercise, and obesity. These are the same risk factors that enhance the probability of atheroma forming in the heart (coronary) arteries, which can cause angina and heart attacks.</p> <h3>In a minority of cases</h3><p>Rare triggers of AAAs contain injury or infection of the aorta. As well, certain rare inherited conditions can influence the artery structure. In these abnormal situations an aneurysm may develop at a rather young age.</p> <h2>How typical are abdominal aortic aneurysms?</h2><p>About 6 in 100 men and about 2 in 100 women over the age of 65 have an AAA. It becomes more regular with growing age. However, most people with an AAA are not knowledgeable that they have one. An AAA is uncommon in people under the age of 60.</p> <h2>What is the concern about an abdominal aortic aneurysm?</h2><p>The main concern is that the aneurysm might rupture (burst). The wall of the aneurysm is weaker than a normal artery wall and may not be able to resist the pressure of blood inside. If it ruptures then severe internal bleeding occurs which is often fatal. Of course, most AAAs do not rupture - only a certain proportion (see below).</p> <h2>What are the warning signs of an abdominal aortic aneurysm?</h2><p>Quite often there are no signals or symptoms. At the time of diagnosis, 7 in 10 people with an AAA will not have had any symptoms due to the aneurysm. The ballooning of the aneurysm does not trigger any symptoms except when it gets large enough to put pressure on nearby structures. If symptoms do appear, they are most likely to be mild abdominal or backside discomfort. There are many causes of mild abdominal and back pain. For this reason, the diagnosis could be delayed except when the aneurysm is big enough to be felt by a doctor when he or she inspects your abdomen.<br /><br />From time to time small blood clots form on the inside lining of an AAA. These may break up off and be carried down the aorta and obstruct a smaller artery further on. These blood clots are called emboli and can be harmful. For illustration, total blockage of an artery that delivers a foot may prospect to loss of blood to part of the foot, which can cause problems in the foot and gangrene if left without treatment.<br /><br />If the aneurysm does rupture then you are likely to have sudden severe abdominal and/or back pain. This is commonly soon followed by collapse as the internal bleeding causes a sharp drop in blood pressure.</p> <h2>The best way in which an abdominal aortic aneurysm is diagnosed?</h2><ul><li>Occasionally a medical professionsal feels the stick out of an aneurysm throughout a routine checking of the abdomen. However, many AAAs are too compact to feel.</li><li>An X-ray of the abdomen (often performed for different causes) will show calcium mineral deposits lining the wall of an AAA in a few, but not all, cases.</li><li>An ultrasound check is the easiest way to detect an AAA. This is an uncomplicated evaluation. It is the exact same type of diagnostic scan that expecting a baby women have to look at the baby in the womb. The size of the aneurysm can also be measured by ultrasound. As discussed later, it is important to know the size.</li><li>A more detailed scan, such as a CT scan, is sometimes done. This may be done if your personal medical expert demands to know whether the aneurysm is influencing any of the arteries that come off the aorta. For instance, if the aneurysm entails the section of the aorta where the arteries to the kidneys branch off, doctors need to recognize this info if they prepare to operate.</li></ul> <h2>What is the chance of an abdominal aortic aneurysm rupturing?</h2><p>The chance of rupture is decreased if an AAA is small. As a rule, the risk of rupture raises with improving dimension. This is much like a balloon - the larger you blow it up, the greater the pressure, and the larger the probability it will burst open. The dimension of an AAA can be measured by an ultrasound diagnostic scan. The following gives general threat figures for the size (diameter) of the aneurysm:</p><ul><li>40 mm-55 mm: about a 1 in 100 chance of rupture per year.</li><li>55 mm-60 mm: about a 10 in 100 chance of rupture per year.</li><li>60 mm-69 mm: about a 15 in 100 chance of rupture per year.</li><li>70 mm-79 mm: about a 35 in 100 chance of rupture per year.</li><li>80 mm or more: about a 50 in 100 chance of rupture per year.</li></ul><p>As a rule, for any given size, the risk of rupture is improved in smokers, females, those with high blood pressure, and those with a family historical past of an AAA.</p> <h2>Should everybody with an abdominal aortic aneurysm have surgical treatment?</h2><p>The short answer is no. Medical repair of an AAA is a significant operation and carries threats. A small amount of people will die during, or shortly after, the surgery. If you have a small AAA, the threat of dying generated by surgery is higher than the risk of rupture. Therefore, surgery is usually not suggested if you have an AAA less than 50 mm broad. Nevertheless, regular ultrasound tests will normally be suggested to see if it gets larger over time.<br /><br />Surgery treatment is usually advised if you develop an AAA larger than 50 mm. For these larger aneurysms the chance of rupture is usually higher than the risk of medical procedures. However, if your basic condition of wellness is weak, or if you have specific other medical related issues, this could increase the danger if you have surgical treatment. So, in several situations the conclusion to operate may be a hard one.<br /><br />Emergency surgical procedure is important if an AAA ruptures. On average, about 8 in 10 people who have a ruptured aortic aneurysm will die due to the unexpected significant bleeding. However, emergency surgery is lifesaving in some cases.</p> <h2>What operations are performed?</h2><p>There are a pair of types of surgical operation to restore an AAA.<br /><br />The classic operation is to cut out the negative part of aorta and swap it with an artificial part of artery (a graft). This is a major surgery and, as described, carries certain threat. Some people die for the duration of this operation. Even so, it is productive in a lot of situations and the aneurysm is absolutely fixed. The long-term view is fine. The graft normally works well for the rest of your life.<br /><br />A modern procedure lets the aorta to be fixed by a procedure called endovascular repair. This has become a popular choice in recent years. In this technique a tube is passed up from inside one of the leg arteries into the area of the aneurysm. This tube is then passed across the increased aneurysm and repaired to the good aorta wall applying metal clips. The benefit to this style of fix is that there is no abdominal surgical procedure. This method is thus more secure than the classic operation, and you need to have to spend less time in hospital. A negative aspect is that certain patients have to undergo an additional procedure at a later stage to improve the primary surgery.<br /><br />Operative methods keep going to develop and improve. Your surgeon will advise about the positives and cons of surgery, the different kinds of surgery, and the best method for you.</p> <h2>Other treatments may be important</h2><p>If you have an AAA, you are probably to have a significant amount of atheroma that lines the artery. For this reason, you are at danger of having substantial atheroma structure in other arteries, such as the coronary (heart) arteries and brain arteries. Therefore, you are likely to be at increased risk of developing heart disease (angina, heart attack, etc) and stroke.<br /><br />In fact, most people who develop an aortic AAA do not die of the aneurysm but die from some other vascular problems, such as a heart strike or stroke.<br /><br />Therefore, you should think of doing what you can to minimize the risk of these factors by other means. For example:</p><ul><li>Eat a healthy diet which consists of keeping a low salt intake.</li><li>If you are able, exercise regularly.</li><li>Lose weight if you are overweight.</li><li>Do not smoke cigarettes.</li><li>If you drink alcohol, do so in moderation.</li><li>If you have high blood pressure, diabetes, or a high cholesterol level, they should be well controlled on treatment.</li><li>You may be prescribed a statin drug to lower your cholesterol level and low-dose aspirin to help prevent blood clots from forming.</li></ul><p>See separate booklet called <i>'Preventing Cardiovascular Diseases'</i> for more details.</p> <h2>Screening for abdominal aortic aneurysm</h2><p>Research studies advise that a routine ultrasound check out is beneficial for all men aged 65. This is because most people with an AAA do not have symptoms. Following a program scan, surgery treatment can be offered to men found to have an aneurysm over 50 mm wide. Follow-up scans can be provided to monitor those with smaller aneurysms.<br /><br />In early 2008, the authorities released that over the subsequent five years ultrasound screening would be rolled out to enable all men in England aged 65 and over to be screened. Screening is likely to begin in Scotland in 2011. Wales and Northern Ireland have yet to announce their plans. Screening for AAA is offered only to men, as the condition is much more typical in men than in women. One study shared in 2009 predicted that if all men in their 60s and 70s were screened in England then this could save nearly 2,000 lives a year. On the other hand, there are some people who have concerns about screening for AAA; for example, see the paper by Johnson cited under 'References', below.</p>

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