Having a family history of aneurysms and a smoking habit could prove to be a deadly combination.
Abdominal aortic aneurysms grow silently with no symptoms and often are only diagnosed when a patient is being screened for something else, according to Dr. Ayman Ahmed, a Marshfield Clinic Health System vascular surgeon.
Leading a healthy lifestyle and getting regular checkups on a known aneurysm can greatly cut that risk.
How abdominal aortic aneurysms form
An aneurysm forms when part of the wall of the aorta weakens and balloons out. The aneurysm can develop due to high blood pressure, blood vessel inflammation, infection, atherosclerosis or as a result of trauma or smoking.
“Abdominal aortic aneurysm development is a complex multifactorial process involving destructive remodeling of the aortic wall connective tissue,” Dr. Ahmed said.
Risk factors for abdominal aortic aneurysm
Abdominal aortic aneurysms are more likely to develop in the following people:
- Age 65 and older
- Family history of abdominal aortic aneurysm
- Personal history with other types of aneurysms
- Male and Caucasian
“Smoking is the strongest risk factor for aortic aneurysm development as it can weaken the walls of the aorta and it does increase the risk of aneurysm formation as well as aneurysm progression and rupture,” Dr. Ahmed said. “The longer and more you smoke the greater the chances of developing an aortic aneurysm.”
Abdominal aortic aneurysm treatment
How an aortic aneurysm is treated depends upon the size, how fast it is growing and if it is causing other symptoms.
Aneurysms that are smaller with no symptoms may require treatment as simple as regular screening and lifestyle changes such as quitting smoking, controlling blood pressure, eating a healthy balanced diet and exercising regularly.
“Patients need to stay alert for symptoms of rupture as a ruptured abdominal aortic aneurysm is an emergency,” Dr. Ahmed said.
Patients who notice dizziness or feel faint or notice a tender spot in the abdomen that pulses with heartbeats should seek immediate help.
If the aneurysm is large, rapidly growing or symptomatic, surgery may be warranted.
“Currently there are two surgical options for treating abdominal aortic aneurysms including open surgery or endovascular repair,” Dr. Ahmed said.
With open surgery, a single large incision is made in the abdomen, the aneurysm is opened and a graft is put into the artery and sewn in place. “It requires more operative time, more stress on the heart and the body and a longer recovery time,” Dr. Ahmed said. “However, this may be the only way to repair the aortic aneurysm in some patients.”
A second option is endovascular repair, which in minimally invasive and may lead to a faster recovery. The size and shape of the person’s blood vessel will determine if the procedure can be done.“
Endovascular repair is done through punctures made in both groins followed by a compressed graft delivered into the artery and placed from the inside to exclude the aneurysm from the blood flow under X-ray guidance,” Dr. Ahmed said.
Regular screening necessary for known aneurysms
If left untreated, the aneurysm is at risk for rupture, which could be fatal.
“Aneurysms tend to grow silently most of the time with no symptoms and at a certain size the risk of rupture becomes significant,” Dr. Ahmed said. “Sudden onset of severe abdominal, back or flank pain in a patient with a known aneurysm could be a sign of rupture or impending rupture.
Those with known aneurysms should enroll in regular screening through ultrasound or CT scan.
To determine if you are at risk for developing an aortic aneurysm, talk to your provider.