Treating The Potentially Deadly Abdominal Aortic Aneurysm

Medically Reviewed by William A. Jackson, MD

When the walls weaken in one of the important blood vessels carrying blood to the body, the danger of a deadly rupture exists.  McLeod Vascular Surgeon Dr. William C. Jackson explains various treatments for an Abdominal Aortic Aneurysm.

Here are highlights from Dr. Jackson’s comments:

An aneurysm is technically defined as a bulging or ballooning or outpouching of an artery that’s greater than 1.5 times the diameter of that artery. In layman’s terms, it’s a ballooning of an artery. The most common aneurysm in the body is in the aorta below the kidney arteries. The aorta is the main blood vessel in the body. It carries blood from the heart, all the way to your belly organs and to your legs. The most dangerous risk of an aneurysm is if the abdominal aorta ruptures — where the aorta aneurysm bursts, resulting in a serious bleeding event. That could be a medical emergency and potentially lead to death. To prevent a rupture, we repair aneurysms when they reach certain size criteria. The aneurysm size criteria for a female is 5 centimeters, and for a male, it’s 5.5 centimeters.

We know that the biggest risk for an aneurysm is smoking.  Number two is a family history of an aneurysm. If your mother or your father or brother or sister had an aneurysm, you’re at a higher risk of having one.
 
If we find a patient who has an aneurysm, we recommend that their relatives be screened for an aneurysm.
 
If it’s below size threshold for repair, we’ll establish a surveillance program, where the patient comes and sees me at regularly scheduled intervals.
 
There’s the classic option for repair that’s been around since the beginning of vascular surgery. That’s an open aortic aneurysm repair. It requires a sizable abdominal incision, clamping the aorta and sewing in a graft to replace that aortic aneurism. Beginning in the late 1990s, early 2000s, an endovascular method allowed us to go inside the arteries to place what we call a stent graft. That’s just a metal stent with fabric around it. We deploy the stent inside the aorta and the aneurysm. It effectively realigns the aneurysm, so the blood flows through the graft and it can’t flow into the aneurysm anymore. It’s a less risky, less invasive way of treating an aneurysm. Today, it’s remains our first line preferred therapy for most patients.
 
Whenever you perform an open aneurysm repair, that’s generally a 5 to 7 day hospital stay. The patients go home, they continue to recover, and then we enroll them in a surveillance program. If you have an endovascular aneurysm repair, where we place the stent graft inside the artery, those patients go home generally the next day. They recover quicker. We do have to survey their graft with imaging every so often.

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