Abdominal aortic aneurysm (AAA) is a localized dilatation of the abdominal aorta, that exceeds the normal diameter by more than 50%. The normal diameter of the infrarenal aorta is 2 cm. The aneurysm can extend to include one or both of the iliac arteries. AAA is caused by a degenerative process of the aortic wall.
Possible symptoms os AAA include low back pain, flank pain, abdominal pain, groin pain or pulsating abdominal mass. However, as most of the AAAs are asymptomatic, their presence is usually revealed during an abdominal examination for another reason - the most common being abdominal ultrasonography. It is recommended that men aged 65 to 75 years who have ever smoked have one-time screening for abdominal aortic aneurysm by ultrasonography. A physician may also detect the presence of an AAA by abdominal palpation.
ABDOMINAL AORTIC ANEURYSM TREATMENT
An aneurysm is usually considered to be present if the measured outer aortic diameter is over 3 cm (normal diameter of aorta is around 2 cm). For aneurysms under 5 cm, the risk of rupture is low, so surgery is not recommended. Such aneurysms are therefore usually kept under surveillance until such time as they become large enough to warrant repair, or develop symptoms.
Surgery is considered for aneurysms larger than 5 cm.
AAA can be repaired in two ways:
- Open aneurysm repair (OR): Open repair (operation) is indicated in young patients as an elective procedure, or in growing or large, symptomatic or ruptured aneurysms.
- Endovascular aneurysm repair (EVAR): It is generally indicated in older, high-risk patients or patients unfit for open repair. However, endovascular repair is feasible for only a proportion of AAA's, depending on the morphology of the aneurysm. The main advantage over open repair is that the peri-operative period has less impact on the patient i.e. less time in intensive care, less time in hospital overall, earlier return to normal activity.
ABDOMINAL AORTIC ANEURYSM COST AND AVAILABILITY
In the US, abdominal aortic aneurysm repair surgery can be very costly. If you are uninsured or underinsured then this could translate into a substantial out-of-pocket expense for your cardiac treatment.
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