Abdominal aortic aneurysm : Treatment

Abdominal aortic aneurysm :  Treatment

Summary

    An abdominal aortic aneurysm presents, sometimes, a fatal pathology that consists of embrittlement accompanied by an abdominal aorta dilation. The abdominal aorta is the largest artery that carries blood from the heart through the thorax and into the abdomen. Some aneurysms can remain stable, while others can present a danger to the body when the aorta becomes so thin to become susceptible to rupture. Thus, they can lead to internal bleeding. The good news for people with aneurysms is that this disease is curable due to various treatments that can even prevent a certain rupture before it occurs.

    How is an abdominal aortic aneurysm diagnosed?

    Generally, abdominal aortic aneurysm is not detected by any specific symptoms, especially at the beginning. Instead, it can be diagnosed through medical examinations such as ultrasound and MRI, and CT scans of other pathologies. These examinations allow clear visualization of the aorta in order to detect any abnormality. Following the diagnosis, the practitioner can determine the stage of the aneurysm detected:

    • Small abdominal aortic aneurysm: it does not present any symptoms, nevertheless, a regular follow-up is recommended to prevent any risk of complication
    • If the diameter of the abdominal aorta is more than 5 cm or equal to it, the aneurysm is well manifested.

    A preoperative workup should be performed to assess the size and location of the aneurysm. This can also help monitor heart and lung function and detect the occurrence of other possible aneurysms in the legs and knees. Rupture of the aorta may be evidenced by abdominal or back pain felt by the patient, which requires urgent intervention to prevent or stop bleeding. If the aneurysm is very large, the patient may have a pulsating mass in the abdomen.

    Treatment of abdominal aortic dilation

    An abdominal aneurysm can be treated either by medical care, open surgery, or by endovascular repair. Thus, the treatment considered depends on the aneurysm size and location.

    Monitoring and medical care

    To monitor the evolution of the aneurysm, it is advisable to perform medical imaging examinations with blood pressure control. However, the importance of smoking cessation and regular exercise should not be overlooked. A reduction in cholesterol levels is also recommended as part of a healthy lifestyle.

    Aneurysm's open surgery

    Surgery for abdominal aortic aneurysms is still indicated once the aneurysm exceeds 5 cm, with a major risk of rupture. The surgical treatment consists in approaching the affected aorta, through an open procedure, to replace it with a prosthesis, the so-called aortic graft. This is presented as a synthetic tube that replaces the abdominal aortic aneurysm portion. If iliac artery involvement is detected, the implant must be extended. However, the surgery may present a risk of postoperative complications due to the opening of the abdomen. For this reason, a more long convalescence period is strongly recommended.

    Endovascular repair (aortic stenting)

    Endovascular repair is a less invasive technique than open surgery and consists mainly of inserting a stent graft into the arterial lumen (the aneurysmal aorta). This treatment does not require opening the abdomen, a simple incision in the groin to introduce this small mesh tube is sufficient to prevent rupture of the aorta. The technique is performed under local or general anesthesia with a shorter recovery time than surgery. In addition, the risk of mortality is much lower.

    Prevention of abdominal aortic aneurysm

    To reduce the risk of the occurrence or development of an aneurysm, it is important to :

    • Follow a balanced diet
    • Stop smoking
    • Practice regular physical activity
    • Control diabetes and blood pressure

    These are risk factors that should not be neglected and should be monitored regularly. For more prevention, specialists advise performing a systematic screening generally after 65 years by Doppler ultrasound to evaluate the diameter of the abdominal aorta.



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