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ABDOMINAL AORTIC
ANEURYSMS
Questions and Answers About ABDOMINAL AORTIC ANEURYSMS
1. What
is the aorta?
2. What is an aneurysm?
3. What is an abdominal aortic aneurysm?
4. What dangers are associated with an abdominal
aortic aneurysm?
5. I don't think I ever heard of aneurysm. Is it
common?
6. How do I know if I have an aneurysm?
7. What causes an aneurysm to rupture?
8. Can physical activity cause an aneurysm to
rupture?
9. Can aneurysm be treated with medicine?
10. How is an aneurysm repaired?
11. What is an ENDOGRAFT?
12. What are the drawbacks to endograft repair?
13. What is the risk of rupture following endograft repair?
14. What is the risk of ENDOLEAK following endograft repair?
15. Will
Medicare pay for ultrasound screening of abdominal aortic aneurysm?
16. What doctors treat abdominal aortic aneurysms at UAMS Medical Center?
Making an Appointment
at UAMS Medical Center
To make an appointment, call 1-501-686-8000.
Questions and Answers About Abdominal
Aortic Aneurysms
1.
What is the aorta?
The aorta is the largest blood vessel in the body and travels from the heart into the
chest and abdomen. It is approximately the same size as a garden hose or about 2 cm in
diameter.
2.
What is an aneurysm?
An aneurysm is a bulge or dilation of an artery due to weakness in the artery wall. The
most common locations for aneurysms are in the brain (cerebral aneurysm) and the abdomen
(abdominal aortic aneurysm).
3.
What is an abdominal aortic aneurysm?
An aneurysm is a bulge in the wall of an artery due to weakness in the wall. An abdominal
aortic aneurysm is a localized bulge in the abdominal aorta. It occurs in about 5% of men
over the age of 60. It is less common in women.
4.
What dangers are associated with an abdominal aortic aneurysm?
The chief risk associated with abdominal aortic aneurysm is rupture. Rupture results in
sudden internal bleeding that is usually fatal unless emergency surgery is undertaken.
Aneurysms may also develop blood clots on the inside. Blood clots can break loose and
travel to the legs and interfere with blood supply. Large aneurysms may compress adjacent
structures such as veins or bowel.
5. I
don't think I ever heard of aneurysm. Is it common?
Conway Twitty and George C. Scott (Patton) both died from ruptured aneurysms.
6.
How do I know if I have an aneurysm?
In thin patients, an aneurysm can be detected by your physician during a careful physical
exam. In larger patients, ultrasound is a painless method of detecting an abdominal
aneurysm. If you have a brother or father with an aneurysm, you are at a higher risk of
developing one as well.
7.
What causes an aneurysm to rupture?
The factors that cause aneurysm rupture are not completely understood. It is known that
aneurysm rupture is related to the size of the aneurysm. In other words, large aneurysms
are more likely to rupture than small ones. Aneurysm size can be determined by physical
exam or through special x-ray tests such as an ultrasound or CT scan.
8.
Can physical activity cause an aneurysm to rupture?
It has never been proven that physical activity causes aneurysm rupture. I generally do
not restrict physical activity such as riding a lawnmower, horseback riding, golf and
tennis. Activities that cause transient severe increase in blood pressure should probably
be avoided - such as heavy weight lifting, especially holding one's breath. We recommend
that most abdominal aneurysm patients continue with normal moderate physical activity.
There is no valid reason to avoid sexual activity.
9.
Can aneurysm be treated with medicine?
There are no known medical treatments for abdominal aneurysm. If you have high blood
pressure, you should keep it under good control. Otherwise, treatment of abdominal
aneurysm requires surgical repair.
10.
How is an aneurysm repaired?
Aneurysm repair is one of the oldest surgical procedures. The first abdominal aneurysm was
repaired in 1951. The aneurysm is surgically removed and a synthetic graft is used to
replace the diseased segment. The operation is standardized and well tolerated although it
does require a large abdominal incision. Patients typically experience a hospital stay of
5 - 7 days. The operation has an excellent rack record and is almost always a permanent
fix.
11.
What is an ENDOGRAFT?
An endograft is type of self-expanding sleeve that can be inserted into an artery to
reinforce the artery and prevent rupture. The FDA approved the use of two
commercially-available endografts in September 1999 for the treatment of AAA. Since that
time, approximately 15,000 endografts have been used in the US. The chief advantage to an
endograft is that the operation is minimally invasive and the recovery time is much
shorter than with other surgical procedures.
12.
What are the drawbacks to endograft repair?
There are some significant drawbacks to endograft repair. Rupture has been reported in a
very small number of patients. Sometimes the endograft does not completely seal off blood
flow from the aneurysm. This condition is called an endoleak. An endoleak must be detected
by a follow-up examination following placement of an endograft.
13.
What is the risk of rupture following endograft repair?
Despite proper placement of an aortic endograft, there is a slight risk of eventual
aneurysm. The risk of aneurysm rupture has been reported to be 0.8% of 6000 Aneurex
grafts. The risk of rupture with Ancure grafts appears to be lower. Overall freedom from
aneurysm rupture with the Aneurex endograft has been calculated to be 97.9% at 3 years.
Careful follow-up is necessary to detect aneurysm expansion or rupture.
14.
What is the risk of ENDOLEAK following endograft repair?
In some cases the endograft does not completely prevent the leakage of arterial blood into
the aneurysm sac. Endoleaks occur in 10-25% of aneurysms treated with endografts. Some
surgeons believe that these so-called endoleaks increase the risk of aneurysm expansion or
rupture. Other experts are unsure of the significance of endoleaks. Endoleaks are detected
by careful postoperative monitoring with periodic CT scans, ultrasounds and sometimes
arteriograms. If an endoleak is detected, it must be classified according to type, and its
significance must be assessed. In some cases, additional procedures may be recommended to
stop the endoleak. In other cases, a period of careful observation for aneurysm expansion
may be appropriate.
15.
Will Medicare pay for ultrasound screening of abdominal aortic aneurysm?
Generally, Medicare does not cover screening exams. We offer free screening for abdominal
aortic aneurysms at UAMS. To find out more or to schedule your free screening, call UAMS
at 686-5318.
16. What doctors treat abdominal aortic
aneurysms at UAMS Medical Center?
UAMS Medical Center Surgeons
John
F. Eidt, M.D.
Director, Division of Vascular Surgery;
Professor of Surgery
Carlos
P. Cruz, M.D.
Assistant Professor of Surgery
"If you have a specific question to ask, click on the following link and fill out
the form to send a question to Dr. Eidt. He will respond to your question via email."
http://www.vascular.uams.edu/AsktheDoc.htm
Making an Appointment at
UAMS Medical Center
To make an appointment, call 1-501-686-8000.
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