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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 almost always causes no symptoms except when it ruptures (bursts). A ruptured abdominal aortic aneurysm is usually dangerous. An [http://abdominalaneurysm.wikidot.com/ abdominal aortic aneurysm] much less than 50 mm wide holds a decreased probability of rupture. A surgery to repair the aneurysm will be recommended if it is larger sized than 50 mm, as earlier mentioned this size the chance of rupture improves. Males 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 biggest 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 normal artery wall. The force of the blood inside of 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 appear in any artery, but they most usually happen in the aorta. Most aortic aneurysms take place in the segment of the aorta that goes through the abdomen. These are known as abdominal aortic aneurysms (AAAs). Sometimes they occur in the section going through the chest. These are known as thoracic aortic aneurysms.<br /><br />The standard 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 dimensions. As a rule, as soon as you strengthen an AAA, it tends progressively to obtain larger sized. The rate at which it becomes larger differs from person to person. In spite of this, on average, an AAA leads to get larger by about 10% every year.</p>

<h2>What causes an abdominal aortic aneurysm?</h2>
<h3>In the majority of cases</h3><p>The exact reason why an aneurysm forms in the aorta in most cases is not well-defined. Most cases take place in older people. An AAA is rare in people less than the age of 60. For that reason, getting old has a main factor to play.<br /><br />The wall of the aorta typically has layers of sleek muscle, and layers created from tissues called elastin and collagen. Elastin and collagen are strong boosting tissues. What seems to happen is that a part of the aorta loses its usual strength and flexibility in some people as they get older. Scientific tests suggests that this is because of to changes in the elastin, collagen and smooth muscle tissues. There seem to be complicated biochemical processes that lead to these changes. Some people are more vulnerable than others to these changes.<br /><br />Your genetic make-up performs a part, as you have a much higher chance of getting an AAA if one of your parents has, or had, one.<br /><br />Atheroma could additionally play a part. Atheroma is a oily substance that stores within the inside lining of arteries. Atheroma is sometimes called furring of the arteries. Most AAAs are layered with some atheroma. Anyone can develop atheroma, but it develops more often with increasing age. A number of risk aspects also enhance the chance of atheroma growing. They include: tobacco use, high blood pressure, diabetes, raised cholesterol level, taking little exercise, and obesity. These are the same risk factors that increase 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 causes of AAAs include injury or infection of the aorta. Also, certain unusual inherited circumstances can influence the artery framework. In these unusual 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 common with raising age. However, most people with an AAA are not careful that they have one. An AAA is uncommon 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 could rupture (burst). The wall of the aneurysm is weaker than a natural artery wall and may not be able to resist the tension 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 signs of an abdominal aortic aneurysm?</h2><p>Often there are no symptoms. At the time of identification, 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 nearby structures. If signs or symptoms do happen, they are likely to be mild abdominal or back discomfort. There are many triggers of mild abdominal and back pain. For that reason, the identification may be postponed except when the aneurysm is large enough to be sensed by a doctor when he or she inspects your abdomen.<br /><br />Sometimes small blood clots form on the inside lining of an AAA. These may break off and be carried down the aorta and block a smaller artery further on. These blood clots are called emboli and can be threatening. For example, full blockage of an artery that delivers a foot may prospect to loss of blood to part of the foot, which can result in 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 normally 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 professional feels the stick out of an aneurysm in the course of a routine check-up of the abdomen. Nevertheless, many AAAs are too compact to feel.</li><li>An X-ray of the abdomen (often done for other reasons) will indicate calcium stores lining the wall of an AAA in a few, but not almost all, cases.</li><li>An ultrasound scan is the easiest way to detect an AAA. This is a painless evaluation. It is the similar type of 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 executed if your doctor demands to know whether the aneurysm is affecting 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 know this info if they prepare to operate.</li></ul>

<h2>What is the danger of an abdominal aortic aneurysm rupturing?</h2><p>The chance of rupture is lower if an AAA is minimal. As a rule, the risk of rupture raises with growing dimensions. This is much like a balloon - the larger you blow it up, the greater the pressure, and the greater the chance it will burst. The size of an AAA can be tested by an ultrasound 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 improved in smokers, females, those with high blood pressure, and those with a relatives historical past of an AAA.</p>

<h2>Should really everyone with an abdominal aortic aneurysm have surgical procedure?</h2><p>The simple answer is no. Medical repair of an AAA is a significant treatment and includes threats. A small quantity of people will die throughout, or right after, the operations. If you have a small AAA, the risk of death caused by surgical procedure is greater than the danger of rupture. For that reason, surgical procedure is usually not suggested if you have an AAA less than 50 mm wide. Even so, usual ultrasound tests will commonly be suggested to observe if it gets larger over time.<br /><br />Surgery is normally recommended 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 treatments. Nevertheless, if your general state of wellness is bad, or if you have certain other health care problems, this may improve the probability if you have surgery. For that reason, in certain situations the decision to operate may be a difficult one.<br /><br />Urgent situation surgical procedures is necessary 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. Even so, emergency surgery is lifesaving in some scenarios.</p>

<h2>What surgical procedures are performed?</h2><p>There are two types of medical operation to fix an AAA.<br /><br />The classic procedure is to cut out the negative part of aorta and replace it by using an man made element of artery (a graft). This is a main operation and, as described, brings certain danger. Some people die throughout this operation. However, it is productive in a lot of cases and the aneurysm is completely repaired. The long-term prospect is good. The graft commonly works well for the rest of your life.<br /><br />A modern method allows the aorta to be restored by a technique named endovascular repair. This has become a popular solution in the latest years. In this technique a tube is passed up from inside one of the leg arteries into the section of the aneurysm. This tube is then passed throughout the widened aneurysm and fixed to the good aorta wall using metal clips. The benefit to this type of fix is that there is no abdominal surgery. This method is thus safer than the standard surgery, and you need to spend less time in clinic. A disadvantage is that some persons have to undergo an additional procedure at a later stage to perfect the primary procedure.<br /><br />Operative techniques keep going to develop and improve. Your doctor will suggest about the positives and cons of surgery, the different forms of operation, and the best method for you.</p>

<h2>Other treatment options could be necessary</h2><p>If you have an AAA, you are likely to have a significant amount of atheroma that lines the artery. For that reason, you are at risk of having significant atheroma 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 additional vascular conditions, such as a heart harm or stroke.<br /><br />Therefore, you should consider doing what you can to reduce the danger of these disorders 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 often.</li><li>Lose excess weight if you are over weight.</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 booklet called <i>'Preventing Cardiovascular Diseases'</i> for more details.</p>

<h2>Screening for abdominal aortic aneurysm</h2><p>Research analyses recommend that a routine ultrasound check is beneficial for all men aged 65. This is because most people with an AAA do not have symptoms. Following a program diagnostic scan, surgical procedure can be provided 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 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 typical in men than in women. One study shared in 2009 estimated 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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