What is an Abdominal Aortic Aneurysm?

Mr Bicknell explains that most abdominal aortic aneurysms (AAA) have no symptoms at all. If they grow undetected, they can burst (rupture) and cause symptoms all of a sudden. They can also become symptomatic if they grow quickly which can lead to earlier detection. However, most are detected on scans for other reasons or in the aneurysm screening program for men over 65 years old.

Mr Bicknell explains that there three options to manage an AAA. First, we can do nothing and just keep it under surveillance which is suitable for small aneurysms. If they are larger and at risk of rupture, the two treatment options are endovascular (keyhole) repair and open surgery.

Mr Bicknell explains that endovascular repair (keyhole surgery) is one of the main treatment options for abdominal aortic aneurysms (AAA). It involves a medical device called a stent graft. A small cut is made into the groin, and the stent graft is then fed up under X-ray guidance into the aorta. The main advantage over open repair is that there is less trauma, less complications shortly after the operation, and patients can usually go home within a day or two. But, in the long term, there can be leakage around the stent graft into the aneurysm (endoleak), which means there is a higher chance of having further procedures. This also means that you will need more regular follow up.

Mr Bicknell explains that open surgery is one of the main treatment options for abdominal aortic aneurysms (AAA). He explains the steps of the procedure, which involves a large cut in the abdomen. When the aorta is exposed, it is clamped above and below the aneurysm. The aneurysm is then opened up and a fabric tube is sown in. It is a major operation which requires a short stay in high dependency or intensive care unit, around 7-10 days in hospital, and a few weeks or months to recover. The short-term complications are higher than the endovascular (keyhole approach). But the main advantage is that the repair is usually more long lasting.

Mr Bicknell explains that aneurysms usually grow very slowly if they are small, but more quickly if they are larger. Unfortunately, there are no drugs that have been shown to slow the rate of growth. The only advice we can give is to give up smoking if you do smoke.