Abdominal Aortic Stent Graft
Treating Abdominal Aortic Aneurysm (AAA)
The aorta is the main blood vessel that supplies blood to the abdomen, pelvis and legs.
- What is an abdominal aortic aneurysm, also known as AAA?
- Who is at risk for AAA?
- Why is early detection so important?
- What are the symptoms of an abdominal aortic aneurysm?
- How is an abdominal aortic aneurysm diagnosed?
- If you have an AAA, how can it be treated?
- What is the endovascular grafting procedure?
- What is the prognosis for patients with AAA?
- Consults. Referrals. Scheduling. Appointments. – Call RIA Endovascular at 720.493.3406.
An abdominal aortic aneurysm is a condition in which a part of the aorta balloons out or there is a blood-filled bulge. The larger the aneurysm, the more likely it is to break open. When this occurs, it can be life-threatening.
Many Americans are at risk for abdominal aortic aneurysms (AAA). It is the third leading cause of sudden death in men who are 60 and older.
While the exact causes of AAA are not clear, some of the risk factors are:
- Age – Individuals over the age of 60 are most likely to develop this condition
- Gender – AAAs are far more common in men than in women
- Family history of abdominal aortic aneurysm
- Smoking – or past history of smoking
- Clogged arteries
- High blood pressure
- High cholesterol
Most people do not experience any symptoms. It is estimated that more than 1 million people are living with an undiagnosed AAA.
An AAA can develop slowly over many years, often without symptoms. Symptoms can come on suddenly if the aneurysm expands rapidly, rips open or leaks blood within the wall of the blood vessel. This latter condition is called aortic dissection.
Symptoms of rupture include:
- Back or abdominal pain – The pain may be severe, sudden, persistent or constant. It may spread to the groin, buttocks or legs.
- Passing out
- Clammy skin
- Nausea, vomiting
- Rapid heart rate
Your doctor may examine your abdomen and feel the pulses in your legs. Symptoms may include:
- A lump, or mass, in the abdomen
- A pulsating sensation in the abdomen
- Stiff or rigid abdomen
Fortunately, at least 95 percent of these AAAs can be successfully treated if detected prior to rupture.
Early detection can save your life. Approximately 200,000 people in the U.S. are diagnosed with AAA each year.
Most abdominal aortic aneurysms can be detected through a simple ultrasound screening. In this diagnostic test, a sonographer glides an ultrasound sensor over the stomach to view images of the aorta. The procedure is painless and generally takes just a few minutes. The images enable the doctor to look at the aorta to see if an AAA is present, and provide information to estimate the size of the AAA. This helps to identify the best treatment option.
A CT scan of the abdomen can confirm the size of an aneurysm.
A computed tomographic angiogram (CTA) is often used to guide surgical planning.
When detected early, an AAA can be effectively managed to keep it from bursting or rupturing. One of the following is usually recommended:
- Watchful waiting – If the aneurysm is small, your doctor may decide to wait and watch it carefully to see if there are changes in your condition. You will be monitored every 6-12 months for changes in the size of the AAA. Your doctor will likely recommend lifestyle changes such as lowering your blood pressure, modifying your diet, reducing stress, quitting smoking and increasing daily exercise.
- Open surgical repair – A surgeon can make an abdominal incision to replace the section of the aorta where the aneurysm has formed. A synthetic fabric tube, or graft, is surgically placed. Open surgical repair, performed under general anesthesia, takes up to four hours and often requires a hospital stay ranging from 7–10 days.
- Endovascular grafting – This procedure, performed by an interventional radiologist, is a less-invasive alternative to surgical repair because the procedure is performed without a surgical opening of the aorta. The interventional radiologist uses a catheter to place a synthetic fabric tube, called a graft or endograft supported by a metal scaffold (stent), inside the aneurysm. Since this is less invasive than open surgery, the hospital stay tends to be shorter — usually 2–4 days.
Abdominal aortic aneurysm stent grafts are performed to bypass large aneurysms in the abdominal section of the aorta which could otherwise lead to life-threatening rupture. During the procedure, an interventional radiologist advances a catheter through a small incision in the groin to the site of the aneurysm. Through the catheter, the radiologist places a fabric tube (graft) that is long enough to span the bulging area.
The tube is held in place by a stent, which is a metal mesh tube. The stent exerts outward pressure against the graft and artery to keep the graft in position. The blood then flows through the graft and bypasses the aneurysm.
Without the pressure of flowing blood, the aneurysm will eventually shrink and the risk of rupture is greatly reduced.
The outcome is often good if you have a procedure to repair the aneurysm before it ruptures.
However, when an abdominal aortic aneurysm begins to tear or ruptures, it is a medical emergency. Only approximately 1 in 5 patients survive a ruptured abdominal aneurysm. If you have bad back or belly pain, or the pain does not go away, go the emergency room or call 911.
To learn more or have our physicians present a talk at your medical office about this or other topics, contact us at 720.493.3406.