Silent Ballooning of The Abdominal Aorta can be catastrophic.

What is An Aortic Aneurysm (AAA)?

The word aneurysm comes from greek for “widening.” A widened artery is called an aneurysm when the diameter is at least 50% wider than normal, and an abdominal aortic aneurysm is an aneurysm of the aorta. An aneurysm can affect any artery.  Aortic aneurysms may be situated in two areas –  the thoracic aorta (from the heart to the diaphgram)  or the abdomen (between the diaphgragm and where the aorta divides into two at the bottom of the abdomen).

What are the symptoms of an abdominal aortic aneurysm?

The worry is that an aneurysm may eventually become so large that it bursts. The good news, though, is that the risk of a rupture is generally low and surgery will not be required for small aneurysms, and small aneurysms are a lot commoner than large aneurysms. The average GP will see someone present with a burst aneurysm perhaps just once in a career.

Symptoms only occur if the aneurysm ruptures. The rupture may result in medical emergency or the rupture may be “contained” when it remains contained for hours or days. Symptoms are abdominal or back pain, feeling faint, or tenderness over the aneurysm.

How do I know if I have an abdominal aortic aneurysm?

An ultrasound scan is the easiest way to know if you have an AAA.

When should an abdominal aortic aneurysm be repaired?

The risk of surgery has reduced in recent years with technological improvements such as less invasive surgery (such as keyhole surgery). The operation remains a big operation. An operation is recommended when the risk of rupture is greater than the risk of the operation, and the threshold is typically set at a diameter of >5.5cm in men and >5.0 cm in women. Smaller aneurysms have a very low risk of rupture and operative repair is not usually recommended.

 How should an AAA be monitored?

An AAA will need regular monitoring with scans. The frequency of these scans depend on the size of the aneurysm with larger aneurysms expanding more quickly and therefore needing more frequent checks. Overall, AAAs expand at a rate of 0.2 to 0.3cm per year so it will take many years before a small AAA might need surgery.

It’s also important to control raised Blood Pressure and control other cardiovascular risk factors.

AAA Diameter (in cm)Surveillance interval
3.0 to 3.9 cm2 yearly scan
4.0 to 4.5 cm1 yearly scan
4.6 to 5.0 cm6 monthly scan
5.0 cm or greater3 monthly scan

WRITTEN BY: Dr Richard Beatty