Know The Risks: Abdominal Aortic Aneurysms

Most people worry about heart attacks, stroke or cancer when thinking about serious health problems. But abdominal aortic aneurysms (AAA) can be just as dangerous — especially if not found early.

What is an abdominal aortic aneurysm? It happens when the body’s largest artery starts to bulge or swell.

“An abdominal aortic aneurysm is an enlargement or swelling of the aorta,” explained Adam Hicks, MD, board-certified vascular surgeon with Franciscan Physician Network Vascular Surgeons in Indianapolis. “The aorta is the body’s largest artery. When it gets too big, it can become dangerous.”

“It’s like putting a pin in a balloon,” added J. Michael Tuchek, DO, a cardiac and vascular surgeon with Franciscan Health in northwest Indiana. “It pops, and you die about 80 to 90 percent of the time.” This is why awareness, early detection and treatment are critical.

What Is Abdominal Aortic Aneurysm?

The aorta is the main blood vessel in the body. It carries blood from your heart down through your chest and belly. Aneurysms can happen anywhere, but the belly area is the most common.

“Any aneurysm is just an enlarged artery,” said Dr. Hicks. “With AAA, we’re talking specifically about the part of the aorta that runs through the belly.”

“As that aneurysm gets bigger, the walls get thinner,” Dr. Tuchek explained. “It’s like when you blow up a balloon. The more air, the thinner the walls and the higher the chance it will burst.”

What Causes AAA And Who Is At Risk?

There are many abdominal aortic aneurysm causes, including:

• Genetics
• High blood pressure
• High cholesterol
• Smoking

Over time, these risks weaken the artery wall and cause it to enlarge.

“Smoking and high blood pressure both put extra stress on artery walls,” Dr. Hicks said. “If you can quit smoking and keep your blood pressure and cholesterol under control, you’re doing your part to lower your risk.”

The abdominal aortic aneurysm rupture risk increases as the aneurysm grows. That’s why abdominal aortic aneurysm size measurement is important. Knowing the size determines your treatment plan.

“Most AAAs we find are small,” Dr. Hicks said. “If the size is under five and a half centimeters in men — or five centimeters in women — we don’t jump to surgery. We usually monitor it with repeat imaging once a year.”

What Are The Signs And Symptoms?

Most people with AAA won’t feel anything — until it ruptures.

“A small number of people may feel belly or lower back pain,” said Dr. Hicks. “But usually, we only find it during a scan for something else — like a kidney stone or gallbladder issue.”

Preventive screenings can also catch AAA, especially in people at higher risk.

That’s what makes AAA screening so important. Abdominal ultrasound is an easy, noninvasive way to detect an aneurysm. “It’s simple, painless and it could save your life,” Dr. Hicks said.

“When an AAA ruptures, you’ll feel sudden and severe pain in your stomach, back or side. You might also feel nauseous or faint,” Dr. Tuchek added.

What happens if you’re diagnosed with AAA?

If a scan shows you have an abdominal aortic aneurysm, your next step is to meet with a vascular surgeon to talk through your options.

Dr. Tuchek said that abdominal aortic aneurysm surgery isn’t always necessary right away.

“Someone who’s elderly or frail may choose not to have surgery,” he said. “You can live with a small aneurysm rupture-free if you watch it carefully.”

How Is AAA Treated?

If the aneurysm is large or growing fast, you may need surgery. There are two main types:

• Minimally invasive stent graft – “We can treat about 90 percent of cases with a stent graft,” said Dr. Hicks. “We place it through small incisions in the legs to reinforce the blood vessel.”
• Open surgery – “We remove the aneurysm and replace it with a Dacron graft,” said Dr. Tuchek. “It works every single time. It’s one and done.”

Steps You Can Take To Prevent AAA

You can’t change your age or family history, but there’s still a lot you can do to lower your risk for AAA:

• Ask your doctor if you need AAA screening
• Don’t smoke
• Keep your blood pressure and cholesterol in check
• Stay active and eat a heart-healthy diet

“If you have a family history, that’s even more reason to get screened,” said Dr. Hicks.

Talk to your doctor about AAA screening

If you’re 65 or older — or have risk factors like smoking or a family history — talk to your doctor about AAA screening. It’s simple and safe and could save your life.

Find a screening location near you or request an appointment.