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2012-03-29T16:44:51Z

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<h1> Abdominal Aortic Aneurysm</h1>

<p>An abdominal aortic aneurysm is a dilation (ballooning) of section of the aorta that is within the abdomen. An abdominal aortic aneurysm mostly causes no signs of illness until it ruptures (bursts). A ruptured abdominal aortic aneurysm is quite often lethal. An [http://abdominalaneurysm.wikispaces.com/ aorta abdominales] much less than 50 mm broad comes with a decreased probability of rupture. An operation to repair the aneurysm could be advised if it is larger sized than 50 mm, as previously mentioned this size the probability of rupture improves. Individuals aged 65 and over are to be offered 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 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 part of an artery widens (balloons out). The wall of an aneurysm is less strong than a healthy artery wall. The pressure of the blood inside the artery triggers 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 take place in any artery, but they most typically take place in the aorta. Most aortic aneurysms take place in the section of the aorta that passes through the abdomen. These are known as abdominal aortic aneurysms (AAAs). Frequently they occur in the segment moving via the chest. These are known as thoracic aortic aneurysms.<br /><br />The normal diameter of the aorta in the abdomen is related to 20 mm. An abdominal aortic aneurysm is said to be present if a section of the aorta within the abdomen is 30 mm or more in diameter.<br /><br />The rest of this booklet is mainly about AAAs.<br /><br />AAAs vary in measurement. As a rule, at the time you develop an AAA, it leads gradually to obtain bigger. The speed at which it gets larger differs from person to person. In spite of this, on average, an AAA tends to get larger by about 10% per year.</p>

<h2>What causes an abdominal aortic aneurysm?</h2>
<h3>In most cases</h3><p>The actual cause why an aneurysm figures in the aorta in most cases is not well-defined. Most instances occur in aged people. An AAA is rare in people less than the age of 60. Therefore, ageing has a major factor to play.<br /><br />The wall of the aorta normally has layers of smooth muscle mass, and layers built from tissues termed elastin and collagen. Elastin and collagen are powerful encouraging tissues. What seems to happen is that a part of the aorta loses its regular toughness and flexibility in some people as they grow older. Researches advises that this is because of to changes in the elastin, collagen and smooth muscle tissues. There seem to be complicated biochemical processes that trigger these modifications. Some people are more vulnerable than others to these changes.<br /><br />Your hereditary make-up performs a part, as you have a significantly higher chance of happening an AAA if one of your parents has, or had, one.<br /><br />Atheroma could also play a part. Atheroma is a oily substance that deposits within the inside of lining of arteries. Atheroma is in some cases termed furring of the arteries. Most AAAs are lined with some atheroma. Any person can develop atheroma, but it develops more commonly with increasing age. Particular risk aspects also improve the chance of atheroma developing. They include: smoking cigarettes, high blood pressure, 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 causes of AAAs have injury or infection of the aorta. As well, certain uncommon inherited factors can influence the artery framework. In these abnormal situations an aneurysm may develop at a rather young age.</p>

<h2>How regularly occurring 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 increasing age. In spite of this, most people with an AAA are not careful that they have one. An AAA is unusual in people below 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 less strong than a natural artery wall and may not be able to withstand the tension of blood internally. 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 symptoms and signs of an abdominal aortic aneurysm?</h2><p>Usually there are no warnings. At the time of medical 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 it becomes large sufficient to set up pressure on native structures. If symptoms do take place, they are likely to be mild abdominal or back pains. There are many triggers of mild abdominal and back pain. Therefore, the identification could be postponed until the aneurysm is large enough to be felt by a medical expert when he or she inspects your abdomen.<br /><br />In some cases small blood clots form on the inside lining of an AAA. These may break up off and be transported down the aorta and block a smaller artery further on. These blood clots are called emboli and can be threatening. For instance, complete blockage of an artery that supplies a foot may lead to loss of blood to part of the foot, which can cause pain 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 generally soon followed by failure as the internal bleeding causes a sharp drop in blood pressure.</p>

<h2>How is an abdominal aortic aneurysm diagnosed?</h2><ul><li>In some cases a medical doctor senses the bulge of an aneurysm in the course of a routine 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 purposes) will show calcium deposits lining the wall of an AAA in a few, but not all, situations.</li><li>An ultrasound scan is the easiest way to detect an AAA. This is a painless evaluation. It is the similar option of diagnostic scan that pregnant 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 example, if the aneurysm involves the section of the aorta where the arteries to the kidneys branch off, doctors need to find out this information if they prepare to operate.</li></ul>

<h2>What is the probability of an abdominal aortic aneurysm rupturing?</h2><p>The opportunity of rupture is minimal if an AAA is minimal. As a rule, the risk of rupture improves with growing dimension. This is much like a balloon - the larger you blow it up, the greater the tension, and the greater the chance it will burst. The size of an AAA can be assessed by an ultrasound diagnostic scan. The following gives over-all 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 improved in smokers, females, those with high blood pressure, and those with a relatives history of an AAA.</p>

<h2>Should every person with an abdominal aortic aneurysm have surgery?</h2><p>The brief answer is no. Surgical repair of an AAA is a significant procedure and carries risks. A small amount of people will die during, or quickly after, the operations. If you have a small AAA, the probability of loss of life generated by surgical procedures is higher than the threat of rupture. For that reason, medical procedures is often not recommended if you have an AAA less than 50 mm broad. However, standard ultrasound scans will generally be suggested to see if it gets larger over time.<br /><br />Surgical procedures is generally suggested if you develop an AAA larger than 50 mm. For these larger aneurysms the chance of rupture is normally higher than the risk of surgical procedure. But, if your general condition of wellness is poor, or if you have certain other medical related conditions, this may improve the threat if you have medical procedures. So, in certain cases the conclusion to operate may be a problematic one.<br /><br />Urgent situation surgical procedures is required if an AAA ruptures. On average, about 8 in 10 people who have a ruptured aortic aneurysm will die due to the unexpected severe bleeding. Nevertheless, crisis surgery is lifesaving in some situations.</p>

<h2>What procedures are implemented?</h2><p>There are two types of surgery operation to fix an AAA.<br /><br />The traditional operation is to cut out the negative part of aorta and change it with an synthetic part of artery (a graft). This is a main operation and, as described, includes certain risk. Some people die throughout this operation. Nevertheless, it is productive in the majority of situations and the aneurysm is completely repaired. The long-term prospect is good. The graft commonly works nicely for the rest of your life.<br /><br />A newer method makes it possible for the aorta to be fixed by a method called endovascular repair. This has become a popular alternative in recent years. In this method a tube is passed up from inside one of the leg arteries into the section of the aneurysm. This tube is then passed across the widened aneurysm and fixed to the good aorta wall applying metal clips. The advantage to this style of repair is that there is no abdominal surgery. This method is thus less dangerous than the classic surgery, and you require to spend less time in hospital. A negative aspect is that some persons have to undergo an additional surgery at a later stage to refine the early process.<br /><br />Operative methods keep going to develop and improve. Your doctor will suggest about the pros and negatives of surgical procedures, the different kinds of procedure, and the best solution for you.</p>

<h2>Other treatment options could be important</h2><p>If you have an AAA, you are likely to have a substantial amount of atheroma that lines the artery. As a result, you are at danger of having significant atheroma structure in other arteries, such as the coronary (heart) arteries and brain arteries. Therefore, you are likely to be at enhanced 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 other vascular problems, such as a heart strike or stroke.<br /><br />Therefore, you should consider doing what you can to decrease the chance of these disorders by other suggests. For example:</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.</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 leaflet called <i>'Preventing Cardiovascular Diseases'</i> for more details.</p>

<h2>Screening for abdominal aortic aneurysm</h2><p>Research analyses suggest that a routine ultrasound scan is worthwhile for all men aged 65. This is mainly because most people with an AAA do not have symptoms. Following a program scan, surgical procedure can be provided to men found to have an aneurysm over 50 mm wide. Follow-up scans can be offered to monitor those with smaller aneurysms.<br /><br />In early 2008, the governing administration introduced 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 widespread in men than in women. One research released 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. Nevertheless, 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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