Abdominal Aortic Aneurysms

What is an abdominal aortic aneurysm?
An abdominal aortic aneurysm (AAA) is a bulge in the aorta in the abdomen. The aorta is the main blood vessel from the heart that supplies blood to all organs.

A weakening in, or damage to, the wall of a blood vessel causes aneurysms. Several risk factors are known to contribute to this condition, including atherosclerosis (hardening of the arteries), cigarette smoking, high blood pressure and inflammation or infection.

Although aneurysms may occur in any blood vessel, they most commonly occur in the abdomen below the renal arteries. An aneurysm may continue to expand until it bursts – a life-threatening event. The goal of surgery is to repair the aneurysm before the aorta ruptures.

What is the prevalence of AAA?
According to VascularWeb.org, a web site created by the Society for Vascular Surgery, physicians diagnose approximately 200,000 people in the United States with AAA each year. Of those who are diagnosed, almost 15,000 may have AAA threatening enough to cause death from a ruptured aneurysm if they are not treated.

How are aneurysms treated?
Traditional surgical repair of an aneurysm requires open surgery in which a large incision is made from just below the breastbone to the top of the pubic bone. The aneurysm is opened and a vascular graft is sewn in place. Open surgery requires patients to be hospitalized for a week and to recuperate at home for four to six weeks.

Are there less invasive procedures?
Washington University surgeons are experts in performing minimally invasive repair of aneurysms through endovascular (within the blood vessels) procedures. Using this approach, two small incisions are made in the groin. A delivery catheter is guided by an X-ray imaging device through a blood vessel in the leg into the aorta. The graft is placed inside the aneurysm. This endovascular procedure requires patients to stay in the hospital for approximately two days, although some patients have been released as early as 24 hours after undergoing this procedure. Most patients are able to resume their normal activities after only two weeks.

What is the success rate?
Approximately 70 percent of patients who undergo an aneurysm procedure at Barnes-Jewish Hospital are now being treated with this technique. Survival for patients undergoing AAA repair at the hospital is 98.5 percent, one of the best survival rates in the country.

Who performs the procedures?
Vascular surgeons work in conjunction with vascular and interventional radiologists at the School of Medicine to perform these procedures.
VascularWeb.org web page on AAA.

To make an appointment with a Washington University vascular surgeon, please call (314) 747-VASC (8272).