What is an abdominal aortic aneurysm?
An abdominal aortic aneurysm is an enlargement of the lower part of the aorta that extends through the abdominal area (at times, the upper portion of the aorta in the chest can be enlarged). The aorta is the main blood vessel that carries blood from the heart to the rest of the body. Like most arteries, the aorta is elastic, which allows it to be filled with blood under high pressure. An aneurysm develops when the wall of the artery becomes weakened and distended like a balloon. The analogy of a bubble in a garden hose would be appropriate in describing an aneurysm. Aneurysms usually are discovered before they produce symptoms, such as back pain, but like the weakened hose, they may rupture if they become too large. Since a ruptured aneurysm is extremely dangerous and can cause life-threatening bleeding, aneurysms are best corrected by an operation before this happens.
What are some predisposing factors for abdominal aneurysms?
- High blood pressure (hypertension). This speeds up damage to blood vessel walls.
- Arteriosclerosis (also called atherosclerosis). This occurs when the normal lining of the arteries deteriorates, the walls of the arteries thicken, and deposits of fat and plaque block the flow of blood through the arteries. The association of arteriosclerosis with the development of aneurysms is controversial.
- High cholesterol
Who should be screened for abdominal aortic aneurysm?
An abdominal aortic aneurysm (AAA) is a major health risk that may not have related symptoms until a life-threatening event occurs, such as aneurysm rupture. An abdominal ultrasound is a preventive screening tool that can be used to identify an AAA so that prompt treatment can be provided prior to aneurysm rupture.
U.S. Preventive Services Task Force screening guidelines
Currently, Medicare is offering a one-time, free abdominal ultrasound AAA screening to qualified senior citizens as part of its Welcome to Medicare physical. This physical must be conducted within the first 12 months of enrollment in Medicare. Men who have smoked at least 100 cigarettes during their lifetime qualify for the Medicare screening.
This screening recommendation is based on the U.S. Preventive Services Task Force (USPSTF) Screening for Abdominal Aortic Aneurysm: Recommendation Statement. January 2014. Agency for Healthcare Research and Quality, Rockville, Md.
Additional screening guidelines
The Society for Vascular Surgery (SVS) and the Society for Vascular Medicine and Biology (SVMB) recommend abdominal ultrasound AAA screening for these patients:
- All men age 65 years old or older and men as early as age 55 with a family history of AAA
- All women age 65 or older with a family history of AAA or those who have smoked
Cleveland Clinic supports the SVS and SVMB screening recommendations for these patients who have a higher risk of developing an AAA. Coverage for abdominal AAA ultrasound screening may differ, depending on your insurance. Therefore, please contact your insurance provider for specific coverage options before scheduling this test.
What are some different types of aneurysms?
- Abdominal aneurysm — in an artery in the abdomen (mid-section)
- Thoracic aneurysm — in an artery in the chest area
- Cerebral aneurysm — in an artery in the brain (usually treated by neurosurgeons)
- Peripheral aneurysm — in the large arteries that run down the legs and
behind the knees, and occasionally arms
Most aneurysms occur in the abdomen. Abdominal aortic aneurysms occur most frequently in people over age 60 and most commonly at a point in the aorta just below the level of the kidneys. Men are more commonly affected by aneurysms than women.
What are the symptoms of abdominal aneurysms?
Most people are unaware that they have an aneurysm because in most cases, there are no symptoms. However, as aneurysms grow, symptoms may include:
- Pulsating enlargement or tender mass felt by a physician when performing a physical examination
- Pain in the back, abdomen, or groin that may be prolonged and not relieved with position change or pain medication
A ruptured aneurysm usually produces sudden, severe pain and other symptoms such as loss of consciousness or shock, depending on the location of the aneurysm and the amount of bleeding. A ruptured aneurysm requires emergency treatment.