Enlargement of the Main Artery – Aortic Aneurysm

Aortic enlargement – aortic aneurysm

An aneurysm is defined as an enlargement of the artery (aorta) exceeding 50% of its normal diameter. This enlargement can occur in any part of the body. It most commonly affects the abdominal artery (abdominal aortic aneurysm, or AAA for short).

Risk factors for the development of an aortic aneurysm

Although we still do not know exactly why some people develop an aneurysm and others do not, the following factors contribute to the development of an aneurysm:

• Family history of aneurysm formation (e.g. connective tissue disorders)
• High blood pressure
• Smoking
• Arteriosclerosis

Frequency

Screening results showed that approximately 1.7% of men over the age of 65 have an AAA. In women, the figure is only around 0.74%.

Risks of abdominal aortic aneurysm

The main danger is that an aneurysm will rupture, leading to internal bleeding. Those affected lose blood very quickly, which is an absolute emergency. Other risks include the formation of blood clots in the dilation, which can lead to acute vascular occlusion in the legs.

Symptoms of abdominal aortic aneurysm

Those affected usually do not notice anything. This makes the aneurysm a "ticking time bomb". Sometimes back pain occurs, sometimes discomfort in the spine or kidneys. If an abdominal aortic aneurysm ruptures, patients suddenly experience unbearable abdominal pain that radiates to the back, nausea and vomiting. The internal bleeding leads to a life-threatening situation – an emergency that must be treated immediately.

Abdominal aortic screening

To prevent this, screening is recommended from the age of 65. This involves palpating the abdomen and performing a short ultrasound examination. This examination is painless and radiation-free. In addition, the family history of the disease is questioned due to the possible hereditary predisposition.

Special vascular surgical screening examinations are carried out by vascular surgery specialists in many vascular surgery outpatient clinics and practices. Ask your family doctor about this.

If an aneurysm is found, it will be monitored at regular intervals with ultrasound, depending on its size. If it becomes too large, surgery should be performed. Rapid growth of the aneurysm, an unusual shape or the occurrence of symptoms may also indicate the need for surgery. 

There are two different procedures for this:

• In conventional or open surgery, the abdomen is opened. The blood vessel is clamped above and below the dilation, the aneurysm is opened lengthwise and a vascular prosthesis is sutured in as a replacement. After the blood flow is restored, the original vessel wall is placed back around the prosthesis and sutured to protect the surrounding organs.
   
• So-called endovascular procedures use stent prostheses. Here, a wire-reinforced prosthesis is inserted into the aneurysm from the inside via the groin artery. The procedure is less invasive because the abdominal cavity is not opened. 
   

Aftercare

The recovery period lasts 2-3 weeks after treatment with a stent prosthesis and 6-8 weeks after open surgery.

• Risk factors such as smoking, elevated blood lipid levels, diabetes, obesity and others must be brought under control.
• Long-term follow-up with vascular specialists is necessary after both procedures in order to identify and treat problems in good time. These check-ups should be even more frequent after endovascular treatment.