Aortic Aneurysm – Introduction
What is an aortic aneurysm (AA)?
The aorta is the main blood vessel that carries blood from the heart to the rest of the body. It extends from the chest to the abdomen, where it branches into the iliac arteries. The iliac arteries carry blood to lower parts of the body and to the legs. Sometimes, because of aging or other medical conditions such as high blood pressure, a section of the aorta may weaken and begin to bulge like a balloon.
This ballooning can enlarge over time as the walls of the aorta become thinner and stretch. This ballooning of the aorta is called an aortic aneurysm.
Aneurysm can affect any part of the aorta from its origin up to the iliac arteries.
Are these serious conditions?
In its early stages, when an AA or iliac aneurysm is small, it does not pose an immediate health risk. In later stages, if the AA or the iliac aneurysm continues to grow, the walls of the aorta or iliac arteries can become thin and lose their ability to stretch. The weakened sections of wall may become unable to support the force of blood flow. Such an aneurysm can burst, causing serious internal bleeding and death.Aneurysm requires regular monitoring and follow-up using ultrasound or CT scan.
What are some of the symptoms of an AA?
Unfortunately, in most cases patients have no symptoms of an AA. For people who do have symptoms, the most common one is pain. The pain can be in the abdomen, back or chest. It could be anything from a mild pain to a severe pain or tenderness in the mid to upper abdomen or lower back. Some patients feel the aneurysm as a pulsating or throbbing mass in their abdomen.
AA is often discovered during an examination being done for other medical reasons. Most often, asymptomatic aneurysms are found incidentally during CT scan done for some other reason.
How do we treat AA?
When an aneurysm is small, periodic check-up with US or CT scan is required for monitoring. Once it becomes large in size, or is rapidly growing, it is at high risk of bursting needing treatment.
There are two types of treatment for AA:
- Open surgical repair.
- Endovascular or minimally invasive repair using special covered stents called stent grafts.
Stent grafts are much less invasiveand safer treatment option. The procedure involves introducing the stent graft through a 1 cm incision in the groin without opening the abdomen.
What are the advances we offer in our practice?
- The stent grafts are introduced through small incisions in the groin with assistance of closure devices. This implies majority of patients walk home within 1-2 days of the procedure
- Access and expertise with most different types of stent grafts including small profile devices
- Simple straight forward aneurysms are treated using conscious sedation with no general anaesthesia required
- Fenestrated/ branched custom made aortic stent grafts: Quite a few aneurysms are not suitable for standard stent grafts manufactured by different companies. There are special custom made stent grafts that can be designed and made for patients based on their aneurysm anatomy. This includes aneurysms affecting aortic arch in the thorax or within the abdominal aorta. This implies that almost all patients with aortic aneurysm affecting any part of the aorta from the aortic arch and below can be treated using minimally invasive endovascular techniques without resorting to open surgery. Even extremely complex aneurysms are amenable to treatment using this technology