BACKGROUND: The aorta is the largest artery in the body and carries oxygen-filled blood from the heart to other organs. The aorta runs through the chest to the abdomen, where it is then called the abdominal aorta and brings blood to the lower body. In the abdomen, the aorta splits in half to carry blood to each leg. The abdominal aorta is about 1 inch normally, but can expand far beyond what is safe. When an area in the aorta is weak, the pressure from the blood may cause it to expand. This balloon- type bulge, called an aneurysm, has the possibility of bursting, which could result in internal bleeding leading to shock or even death. When the aneurysm ruptures before being treated, only 40 percent of patients survive.

CAUSES OF INJURY: Aneurysms form when the wall of the aorta is weak. Weakness in the wall may be due to inflammation, which researchers believe may be associated with hardening of the arteries or high blood pressure. Hardening of the arteries occurs when plaque builds up inside the artery, and with time, causes the artery to narrow, harden and weaken. Common risk factors also include: being a male over 60 years of age, having immediate family with AAA, high blood pressure and smoking. SYMPTOMS: Abdominal aortic aneurysms typically do not have symptoms. Often times, a AAA is discovered when getting treatment for something else. However, the most common symptom is pain when symptoms are present. The aneurysm may be about to burst when one feels a severe, sudden pain the abdomen of the lower back. Other symptoms may include a pulse or "heartbeat" in your abdomen.

TREATMENT: Surgical Repair: If the aneurysm reaches 5 cm in diameter, treatment is recommended to prevent a burst. Once this danger width is met, the most common solution is surgical repair. An incision is made from right under the breastbone to just above the pubic bone. The aorta is clamped off and the aneurysm is cut off, replacing the abnormal vessel with a graft made of synthetic material. The blood flow then goes through this new "bridge" to avoid the weak aorta wall, no longer irritating it to cause a rupture.

Endovascular Stent Grafting: This technique puts a permanent stent graft, which is a tube composed of fabric and supported by metal, inside the artery. The metal tubes help support the artery without making any major cuts into the abdomen. This procedure is a new technology and is not recommended for everyone. The durability is unknown, and the procedure is not recommended for patients with at least 20 more years in life.

FOR MORE INFORMATION, PLEASE CONTACT:
William Jordan, M.D.
(205) 934-2006
vascularmd@uab.edu