What are the symptoms of an Abdominal Aortic Aneurysm?

Mr Usman Jaffer explains that abdominal aortic aneurysms (AAA) can be caused by a number of different factors. One of these factors is having a family history of aneurysms, so there is a hereditary component. But there are other causes such as atherosclerosis (hardening and narrowing of the arteries) which can happen as part of ageing and having other risk factors such as high blood pressure or smoking.

This gentleman and his wife have kindly agreed to share their experience from the treatment he needed for symptomatic aortic aneurysm repair. He was admitted as an emergency due to increasing abdominal pain, which was related to expanding abdomina aortic aneurysm. He recovered well from the surgery.

Mr Usman Jaffer explains that there are two options to repair an abdominal aortic aneurysm (AAA): endovascular repair (EVAR) and open repair. Open repair is a major operation which mostly commonly involves an incision vertically down the abdomen (belly). The aorta is then found at the back of the abdomen behind the guts. The area of aneurysm in the aorta is then opened and a fabric tube is fixed inside the aorta to strengthen it. Different types of grafts are used depending on where the aneurysm is located and how far it extends.

Mr Usman Jaffer explains that an abdominal aortic aneurysm (AAA) is a swelling in the aorta, which is the main blood vessel taking blood away from the heart down into the abdomen (belly). A small aneurysm has a low risk of rupture (bursting). As the aneurysm gets larger, there is a higher chance of rupture.

The procedure is minimal invasive and can be done purely with needle access through the skin or with small groin cuts to access the Femoral arteries. The aneurysm is repaired by inserting a device on the inside of the arteries to exclude the aneurysm from the circulation. It can be performed either in the operating room or a dedicated interventional angiography suite. The device is inserted in two pieces: the main body from one groin artery and the separate leg from the other groin. A quality control X ray die test is performed to ensure a good seal at the end. Sometimes additional procedures might be necessary, such as: - internal iliac embolization (occlusion) if the distal landing zone is in the external iliac artery, - conduit (additional tube-graft stitched to the native artery) if access vessels are too small, - aorto-uni-iliac stent (stent with only one limb) if the other side is not accessible (example: occluded access vessel) and occlusion of the iliac vessels (iliac arteries originate from aorta within the lower abdomen) and to preserve blood flow to the lower limb femoro-femoral crossover graft is needed. Patients who are treated with EVAR need life-long surveillance for possible graft related complications which may need further procedures to fix them.

Mr White talks about his experience with open Abdominal Aortic Aneurysm surgery at Saint Marys Hospital in London.