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Could I have an abdominal aortic aneurysm?

 

Do abdominal aortic aneurysms give rise to any signs?

How are abdominal aortic aneurysms diagnosed (found)?

Who usually develops an abdominal aortic aneurysm?

What is screening for abdominal aortic aneurysms?

Which abdominal aortic aneurysms require treatment?

What is the watchful wait?

Can I do anything during the watchful wait?

 

 

Do abdominal aortic aneurysms give rise to any signs?

Abdominal aortic aneurysms (AAA) are usually asymptomatic. This means that they do not cause any pain or affect your day to day activities. You therefore do not know that you have one until it is too late, that is when it bursts. In those few patients in whom AAA cause symptoms, these could include:

 

1. a feeling that something is pulsating (like a heart-beat) in your tummy

2. pain in your tummy or back

3. Pain, discoloration, or sores on the toes or feet. This is a rare symptom that results from blood clots within the AAA being shed into the blood. These clots then block small vessels in the feet.

 

If you have any of these symptoms you should contact your general practitioner who will arrange further investigations.

How are abdominal aortic aneurysms diagnosed (found)?

Most AAA are found as an incidental finding. This means that during the course of investigating someone for problems which are neither suspicious of nor related to a AAA, a AAA is found unexpectedly. When this happens the patient should be referred to a vascular surgeon. If the AAA is smaller than 5 cm, because the risk of it bursting is very small, it is very safe to wait for a routine appointment. On the other hand, if your AAA is greater than 5 cm, you should see a vascular surgeon at his first available clinic.

Who usually develops an abdominal aortic aneurysm?

AAA usually occur in 65 year-old men or older. They are rare in younger individuals and uncommon in women. If you have a relative who did have a AAA you may be more likely to have one and should consider having an ultrasound scan. You do not need to have an ultrasound scan before you are 60 years unless your relative was younger than 65 years when he/she was diagnosed with a AAA.

What is screening for abdominal aortic aneurysms?

Since AAA are usually asymptomatic, the best way to find them and prevent them from bursting is by screening. Screening is when we use tests to find a disease/condition before it manifests itself. Screening is not performed in everybody, but only in individuals that have a higher risk of having the condition. In the case of AAA these are men aged 65 years and over. The test we use to screen for AAA is ultrasound. This is similar to what is used in pregnant women.  If you are a man aged 65 years or over and have never had an ultrasound scan of your tummy, you should arrange to have one. You may be able to arrange this through your GP. Alternatively you may email your contact details at AAA@stent-graft.com and we will advise you accordingly. If you are a women aged 65 or more, the risk of having a AAA is thought to be too small (unless you had relatives with a AAA) to justify screening. If you however feel that you would still like to be screened do not hesitate to contact us.

Which abdominal aortic aneurysms require treatment?

Abdominal aortic aneurysms do not require treatment unless their diameter (width) is 5.5cm or larger. The exceptions to this are if the aneurysm is giving rise to symptoms (usually pain) or if it is growing at a faster rate than expected.

What is the watchful wait?

If you do have an abdominal aortic aneurysm but it is still smaller than 5 cm, you will be enrolled in an aneurysm surveillance program. What this means is that you will have regular ultrasound scans at intervals of 3, 6 or 12 months, depending on the size of your aneurysm and its rate of growth. This period of time is known as the watchful wait.

Can I do anything during the watchful wait?

      If you smoke, you should stop.

      If you have high blood pressure, your general practitioner should prescribe blood pressure medication to lower your blood pressure in order to reduce the pressure on the weakened arterial wall that forms the aneurysm.

      Although an aneurysm will not "disappear" without surgery, there are some suggestions that statins (cholesterol lowering medication) may slow its growth and reduce the risk of it bursting

It is however, extremely important to continue to attend the aneurysm surveillance program because the aneurysm may enlarge to a dangerous size over time and could eventually burst, causing death, if this is not detected and treated surgically.