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<h1> Abdominal Aortic Aneurysm</h1> <p>An abdominal aortic aneurysm is a dilation (ballooning) of part of the aorta that is located in the abdomen. An abdominal aortic aneurysm almost always causes no indicators unless it ruptures (bursts). A ruptured abdominal aortic aneurysm is usually fatal. An [http://abdominalaneurysm.webs.com/ aneurisma aortico] less than 50 mm broad comes with a below average risk of rupture. A surgical procedure to take care of the aneurysm could be recommended if it is larger than 50 mm, as earlier mentioned this dimension the chance of rupture grows. Individuals 65 years old and over are to be supplied a routine scan to screen for abdominal aortic aneurysm.</p> <h2>What is the aorta?</h2><p>The aorta is the most significant artery (blood vessel) in the human 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 section of an artery widens (balloons out). The wall of an aneurysm is weaker than a healthy artery wall. The force of the blood in the artery leads to 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 might happen in any existing artery, but they most typically occur in the aorta. Most aortic aneurysms arise in the area of the aorta that goes through the abdomen. These are known as abdominal aortic aneurysms (AAAs). Frequently they occur in the segment heading via the chest. These are known as thoracic aortic aneurysms.<br /><br />The standard diameter of the aorta in the abdomen is around 20 mm. An 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 leaflet is mainly about AAAs.<br /><br />AAAs differ in measurement. As a rule, at the time you strengthen an AAA, it has a tendency progressively to get greater. The rate at which it gets larger ranges from person to person. In spite of this, on average, an AAA tends to get larger by around 10% every year.</p> <h2>What leads to 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 scenarios occur in aged people. An AAA is rare in people less than the age of 60. For that reason, growing old has a major factor to play.<br /><br />The wall of the aorta commonly has layers of sleek muscles, and layers made from tissues known as elastin and collagen. Elastin and collagen are powerful supporting tissues. What seems to happen is that a part of the aorta loses its regular strength and elasticity in some people as they get older. Scientific tests recommends that this is due to changes in the elastin, collagen and smooth muscle tissues. There seem to be difficult biochemical processes that lead to these transformations. Some people are more susceptible than others to these changes.<br /><br />Your genetic make-up performs a part, as you have a significantly higher chance of raising an AAA if one of your parents has, or had, one.<br /><br />Atheroma may as well play a part. Atheroma is a oily substance that stores within the inside lining of arteries. Atheroma is in some cases named furring of the arteries. Most AAAs are lined with some atheroma. Any individual can develop atheroma, but it develops more generally with increasing age. A number of risk factors also improve the chance of atheroma forming. They include: tobacco use, high blood tension, diabetes, raised cholesterol level, taking little exercise, and obesity. These are the same risk factors that increase the chance 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. In addition, certain unusual genetic conditions can affect the artery structure. In these uncommon situations an aneurysm may develop at a rather young age.</p> <h2>How ordinary 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 common with increasing age. Though, most people with an AAA are not aware that they have one. An AAA is not usual in people less than the age of 60.</p> <h2>What is the concern about an abdominal aortic aneurysm?</h2><p>The main concern is that the aneurysm could rupture (burst). The wall of the aneurysm is weaker than a normal artery wall and may not be able to stand up to 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 indicators of an abdominal aortic aneurysm?</h2><p>Often there are no warnings. 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 cause any symptoms unless of course it gets large enough to put force on native structures. If signs do take place, they are likely to be mild abdominal or back discomfort. There are many causes of mild abdominal and back pain. As a result, the diagnosis could be postponed unless the aneurysm is large enough to be felt by a medical professional when he or she examines your abdomen.<br /><br />From time to time small blood clots form on the inside lining of an AAA. These may break off and be taken down the aorta and block a smaller artery further on. These blood clots are called emboli and can be harmful. For instance, complete blockage of an artery that supplies a foot may lead to loss of blood to part of the foot, which can result in pain in the foot and gangrene if left untreated.<br /><br />If the aneurysm does rupture then you are likely to have sudden severe abdominal and/or back pain. This is generally soon followed by crease as the internal bleeding causes a sharp drop in blood pressure.</p> <h2>The way in which an abdominal aortic aneurysm is diagnosed?</h2><ul><li>Occasionally a medical doctor feels the bulge of an aneurysm while in a program checking of the abdomen. However, many AAAs are too small to medium sized to feel.</li><li>An X-ray of the abdomen (often carried out for other reasons) will indicate calcium stores lining the wall of an AAA in some, but not almost all, scenarios.</li><li>An ultrasound scan is the easiest way to detect an AAA. This is an uncomplicated test. It is the same kind 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 doctor requires to know whether the aneurysm is impacting on any of the arteries that come off the aorta. For illustration, if the aneurysm entails the section of the aorta where the arteries to the kidneys branch off, surgeons need to recognize this information if they plan to operate.</li></ul> <h2>What is the threat of an abdominal aortic aneurysm rupturing?</h2><p>The chance of rupture is minimal if an AAA is minimal. As a rule, the risk of rupture raises with improving measurement. This is much like a balloon - the larger you blow it up, the greater the pressure, and the larger the probability it will burst. The dimension of an AAA can be tested by an ultrasound diagnostic scan. The following gives overall risk 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 increased in smokers, females, those with high blood pressure, and those with a family background of an AAA.</p> <h2>Should really everyone with an abdominal aortic aneurysm have surgical treatments?</h2><p>The brief answer is no. Medical repair of an AAA is a major treatment and provides dangers. A small quantity of people will die during, or right after, the treatment. If you have a small AAA, the threat of death triggered by surgical procedure is higher than the risk of rupture. Therefore, medical procedures is normally not suggested if you have an AAA less than 50 mm broad. Even so, usual ultrasound verification will generally be suggested to observe if it gets larger over time.<br /><br />Medical procedures is commonly advised if you develop an AAA larger than 50 mm. For these larger aneurysms the probability of rupture is typically higher than the risk of surgical treatments. In spite of this, if your common state of health is poor, or if you have certain other medical conditions, this could improve the threat if you have surgery. Therefore, in several scenarios the decision to operate may be a hard one.<br /><br />Urgent situation surgical treatment is needed if an AAA ruptures. On average, about 8 in 10 people who have a ruptured aortic aneurysm will die due to the quick significant bleeding. However, urgent surgery is lifesaving in some conditions.</p> <h2>What operations are practiced?</h2><p>There are two types of surgery treatment to repair an AAA.<br /><br />The traditional operation is to cut out the negative part of aorta and swap it by using an man made part of artery (a graft). This is a major procedure and, as described, carries certain risk. Some people die during this operation. However, it is productive in most cases and the aneurysm is absolutely fixed. The long-term prospect is fine. The graft usually works nicely for the rest of your life.<br /><br />A newer technique allows the aorta to be repaired by a procedure called endovascular repair. This has become a popular solution in current 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 fixed to the good aorta wall using metal clips. The advantage to this style of repair is that there is no abdominal surgical procedure. This tactic is thus more secure than the standard surgery, and you require to spend less time in medical center. A negative aspect is that certain patients have to undergo an additional operation at a later stage to improve the primary surgery.<br /><br />Medical methods keep going to develop and improve. Your doctor will suggest about the advantages and cons of surgical procedure, the various types of surgery, and the best solution for you.</p> <h2>Other treatment options may be necessary</h2><p>If you have an AAA, you are likely to have a significant amount of atheroma that lines the artery. As a result, you are at risk of having significant atheroma formation in other arteries, such as the coronary (heart) arteries and brain arteries. Therefore, you are likely to be at improved 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 attack or stroke.<br /><br />Therefore, you should think of doing what you can to reduce the risk of these disorders by other suggests. For illustration:</p><ul><li>Eat a healthy diet which comes with keeping a low salt intake.</li><li>If you are able, exercise regularly.</li><li>Lose excess 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 is worthwhile for all men aged 65. This is due to the fact most people with an AAA do not have symptoms. Following a routine diagnostic scan, surgical procedure can be presented to men found to have an aneurysm over 50 mm wide. Follow-up scans can be supplied to monitor those with smaller aneurysms.<br /><br />In early 2008, the governing administration announced 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 research released in 2009 determined that if all men in their 60s and 70s were screened in England then this could save nearly 2,000 lives a year. Nevertheless, there are some people who have fears about screening for AAA; for example, see the paper by Johnson cited under 'References', below.</p>

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