The treatment for an abdominal aortic aneurysm (AAA) mostly depends on how big it is. AAAs are grouped into 3 sizes: Large AAAs are more likely to burst (rupture), so surgery to stop this happening is usually recommended. The risk of a small or medium AAA bursting is much lower,
so you'll normally be advised to have regular scans to check its size and make healthy lifestyle changes to help stop it getting bigger. Ask your doctor if you're not sure what size your aneurysm is. You might not need treatment if you have a small or medium AAA. This is because the risk of the AAA bursting is smaller than the risk of complications from surgery. You'll be asked to come back for regular ultrasound scans to check if your aneurysm is getting bigger. Scans are done:
Surgery may be offered if the scans show that a AAA larger than 4cms has grown by more than 1cm over 12 months. Surgery may also be offered if you have symptoms linked to AAA, such as a pulsing sensation in your tummy or tummy pain that does not go away. You'll also be told about lifestyle changes that can help reduce the risk of an aneurysm getting bigger, such as eating healthily. Read more about how to stop an aneurysm growing. You can otherwise carry on as normal, although having an AAA may have some implications for things such as driving and getting travel insurance. Read some frequently asked questions about AAAs for more information. Large AAAsIf you have a large AAA, surgery to strengthen it with a piece of manmade tubing (a graft) is usually recommended because the risk of it bursting is bigger than the risk of complications from surgery. There are 2 main types of surgery for an AAA:
Both techniques are equally good at reducing the risk of an AAA bursting, but each has its own advantages and disadvantages. Talk to your surgeon about which is best for you. If surgery is not suitable for you, you'll have regular scans to monitor your aneurysm and be given advice about healthy lifestyle changes. You may also be prescribed medicine to help stop the aneurysm bursting. Endovascular surgeryIn endovascular surgery, a graft is inserted into a blood vessel in your groin through small cuts made in your skin. It's then carefully guided up into the aneurysm. This is usually done under general anaesthetic, where you're asleep. You'll normally stay in hospital for 2 or 3 days after the operation, and it can take a few weeks or months to fully recover. The risk of complications is generally lower than with open surgery, and the hospital stay and recovery time is often shorter. Risks of endovascular surgery include:
Video: abdominal aortic aneurysm - endovascular surgeryThis video shows what happens when you have endovascular surgery for an abdominal aortic aneurysm. Media last reviewed: 1 November 2021 Open surgeryDuring open surgery, a cut is made in your tummy and your surgeon replaces the affected section of aorta with a graft. This is done under general anaesthetic. You'll usually stay in hospital for 7 to 10 days after the operation, and it will take a few weeks or months to fully recover. The risk of complications is generally higher than with endovascular surgery, and the hospital stay and recovery time is often longer. Risks of open surgery include:
The risk of graft problems is lower than with endovascular surgery. The graft will usually work well for the rest of your life and you will not usually need regular scans to check it. Video: abdominal aortic aneurysm - open surgeryThis animation explains what happens when you have open surgery for an abdominal aortic aneurysm. Media last reviewed: 1 November 2021 Treatment for a burst AAAA burst aneurysm is treated with emergency surgery using the same techniques used for a large aneurysm. The decision about whether to perform open or endovascular surgery is made by the surgeon carrying out the operation. Page last reviewed: 21 May 2020 What are the symptoms of a leaking aortic aneurysm?Signs and symptoms that a thoracic aortic aneurysm has ruptured or dissected include:. Sharp, sudden pain in the upper back that spreads downward.. Pain in the chest, jaw, neck or arms.. Difficulty breathing.. Low blood pressure.. Loss of consciousness.. Shortness of breath.. Trouble swallowing.. What are symptoms of an endoleak?Endoleaks typically don't cause any noticeable symptoms. However, if the leaking blood causes the aneurysm sac to expand to the point where it ruptures, it can become a life-threatening emergency.
What happens when an abdominal aortic aneurysm leaks?A ruptured aneurysm can cause massive internal bleeding, which is usually fatal. Around 8 out of 10 people with a rupture either die before they reach hospital or don't survive surgery. The most common symptom of a ruptured aortic aneurysm is sudden and severe pain in the abdomen.
What happens if a stent leaks?Endovascular stent grafts can sometimes leak blood through the areas where the graft components join together, or they can allow blood to leak back into the aneurysm sac through small arteries feeding the aneurysm sac. These leaks are called "endoleaks". Some of the leaks stop by themselves and are not dangerous.
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