ABC of Vascular Disease
1. What is an aortic aneurysm?
aortic aneurysm is a swelling of the main artery in the abdomen that is called
the aorta. The aorta carries blood
from the heart to the internal organs and legs and is normally about 2.5 cm (1
inch) in diameter.
2. What causes an aortic aneurysm?
Arteries have elastic walls and pulsate in time with
the beat of the heart. Over many
years the wear-and tear on the wall of an artery can cause it to weaken.
If this happens the artery will increase in size because of the blood
pressure inside. If the artery
expands to more than twice its normal size it is called an aneurysm.
Aortic aneurysms are most common in men over 60 years old.
Men are more likely to have an aortic aneurysm if their father or
grandfather had the same condition.
3. How do you diagnose an aortic aneurysm?
Many aortic aneurysms do not cause any symptoms and are
only diagnosed during examinations or tests for other conditions.
You can look for aortic aneurysms deliberately and this is called
screening (Aortic Screening). An examination of the
abdomen by an experienced doctor is usually all that is required to diagnose an
aortic aneurysm. The exact size of an aortic aneurysm can be measured quite
easily using an ultrasound machine. More
accurate measurements and pictures of the aneurysm may be obtained using a
computed tomography (CT) machine. Knowing
the size and extent of the aortic aneurysm is important in the planning of any
4. What will happen if I have an aortic aneurysm and I do nothing about
An aortic aneurysm will slowly increase in size.
The bigger an aortic aneurysm gets the more likely the wall of the aorta
will fail and the blood will leak out (haemorrhage).
A leaking aortic aneurysm is a very serious, life-threatening situation
and one in ten people survive this complication. The only chance of
survival is an emergency operation but many patients do not reach a vascular
surgeon in time!
5. What treatment is required for an aortic aneurysm?
to replace the damaged aorta is the only effective treatment that will
prevent the aneurysm from leaking. Once
an aneurysm has increased to more than 5.5 cm in diameter then the risk of a
leak becomes significant and surgery should be considered.
The operation involves replacing the affected part of the aorta with an
artificial, woven, plastic bypass graft. The
operation to repair an aortic aneurysm is a major undertaking and also carries
significant risks. If you have an
aneurysm less than 5.5 cm then it is actually safer to monitor the size and
growth of the aneurysm than to operate too early.
6. What will happen if I need an
operation on my aortic aneurysm?
The operation should be done by a
qualified vascular surgeon who specialises in this type of surgery and requires
a full (general) anaesthetic. During the operation the aorta is exposed
through an incision in the tummy and the damaged part replaced with an arterial
graft. After the operation it is usual to spend some time in the intensive
care unit for close monitoring and the average stay in hospital is about 10
days. Major surgery like this does carry the risk of complications and
your surgeon will discuss these issues with you before you sign the consent
form. (See Aortic Aneurysm Repair)
long does it take to recover?
operation like this takes weeks to months to recover from fully, even in fit
people. It is normal to lose between 1 and 2 stones in weight and this
weight is only put back on slowly over several months. During this time
you can expect to suffer from "lack of energy" and it is sensible to
get plenty of rest to give the body the best chance to recover. Good diet
and increasing amounts of exercise also help to speed recovery.
the aneurysm come back?
The good news is that 95% of people
have no major problems with the surgery and the likelihood of serious problems
arising after successful surgery is low. The arterial graft cannot develop
an aneurysm and after surgery you should be able to forget about the problem.