AORTA
Aneurysm
The aorta is the main artery from which all organs in the body receive their arterial blood supply. Arterial blood contains oxygen and other nutrients. This is delivered to the various organs by means of the heart that pumps blood through the arteries to the organs.
The aorta is the largest artery in your body and it carries blood away from your heart. Your aorta runs through your chest, where it is called the thoracic aorta. When it reaches your abdomen, it is called the abdominal aorta. The abdominal aorta supplies blood to the lower part of the body. Just below the abdomen, the aorta splits into two branches that carry blood into each leg.
Abdominal aortic aneurysm
When a weak area of the abdominal aorta expands or bulges, it is called an abdominal aortic aneurysm (AAA). The pressure from blood flowing through your abdominal aorta can cause a weakened part of the aorta to bulge, much like a balloon. A normal aorta is about 16 to 18 mm in diameter. However, an AAA can stretch the aorta beyond its safety margin (> 55mm). Aneurysms are a health risk because they can burst, or rupture. A ruptured aneurysm can cause severe internal bleeding, which can lead to shock and even death.
An aneurysm can cause another serious health problem: blood clots or debris can form inside the aneurysm and travel to blood vessels leading to other structures in your body. If one of these blood vessels becomes blocked, it can cause severe pain or even limb loss.
Each year, physicians diagnose approximately 200 000 people in the United States with AAA. Of those 200 000, nearly 15 000 may have AAA threatening enough to cause death from a ruptured aneurysm if not treated.
Fortunately, when diagnosed early, AAA can be treated, or even cured, with highly effective and safe treatments.
Symptoms
Although you may not feel any symptoms with AAA, if you develop symptoms, you may experience one or more of the following:
A pulsing feeling in your abdomen, similar to a heartbeat above your belly button
Severe, sudden pain in your abdomen or lower back. If this is the case, your aneurysm may be about to burst
If your aneurysm bursts, you may suddenly feel intense weakness, dizziness, or pain and you may lose consciousness. This is a life-threatening situation and you should seek medical attention immediately
Causes
Physicians and researchers are not quite sure what causes AAA. The leading thought is that the aneurysm may be caused by inflammation in the aorta, which may cause its wall to break down. Some researchers believe that this inflammation can be associated with atherosclerosis (also called hardening of the arteries) or risk factors that contribute to atherosclerosis, such as high blood pressure (hypertension). In atherosclerosis fatty deposits, called plaque, build up in an artery. Over time, this buildup causes the artery to narrow, stiffen and possibly weaken. Besides atherosclerosis, other factors that can increase your risk of AAA include:
Age: Being older than 60 years
Genetics: Immediate relative who has had AAA
High blood pressure (hypertension)
Smoking
Gender: AAA is more common in men than in women
Tests
Abdominal aortic aneurysms can be palpated during clinical examination. They are most often found when a physician is performing an imaging test, such as an ultrasound, for another condition. If your physician suspects that you may have AAA, he or she may recommend one of the following tests:
Abdominal ultrasound
Computed tomography (CT) scan
Magnetic resonance imaging (MRI)
Treatment Options
Watchful Waiting
Your physician may recommend "watchful waiting," which means that you will be monitored every 6 months for signs of changes in the aneurysm size. Your physician may schedule you for regular CT scans or ultrasound examinations to watch the aneurysm. This method is usually used for aneurysms that are smaller than 55mm. If you also have high blood pressure, your physician may prescribe blood pressure medication to lower your blood pressure and lower the pressure on the weakened area of the aneurysm.
Surgical Repair
A vascular surgeon may recommend that you have a surgical procedure called an open aneurysm repair if your aneurysm is causing symptoms or is larger than 55mm, or is enlarging rapidly under observation. During an open aneurysm repair, also known as surgical aneurysm repair, your surgeon makes an incision in your abdomen and replaces the weakened part of your aorta with a tube-like graft. This graft is made of man-made material, such as polyester, in the size and shape of the healthy aorta. The tube strengthens your aorta and allows blood to pass easily through it. Following the surgery, you may stay in the hospital for 5 to 7 days. You may also require 2 to 3 months for a complete recovery. More than 95 percent of open aneurysm repair are successful for the long term.
Endovascular Repair
Instead of open aneurysm repair, your vascular surgeon may consider a newer procedure called an endovascular abdominal aortic aneurysm repair with an endovascular stent graft. Endovascular means that the treatment is performed inside your body using long, thin tubes called catheters that are threaded through your blood vessels from the groin. This procedure is less invasive, meaning that your surgeon will make only small incisions in your groin area through which to thread the catheters. During the procedure, your surgeon will use live x-ray pictures on a screen to guide a fabric and metal tube, called a stent graft, to the site of aneurysm. Like the graft in open surgery, the endovascular stent graft also strengthens the aorta. Your recovery time for endovascular stent graft is much shorter than surgery, and your hospital stay is reduced to 2 to 3 days. However, this procedure is more likely to require periodic maintenance than the open procedure. In addition, you may not be suitable to have this procedure, since not all patients are candidates for endovascular repair. In some cases, open aneurysm repair may be the best way to cure AAA.
Open Surgical Repair
Endovascular Repair
Our Services
Arterial
Procedures
Standard open arterial surgical procedures to repair aorta aneurysm and / or reconstruct blood flow to the lower extremities.
Open aorta aneurysm repair
Aorta-bifemoral bypass
Iliofemoral bypass
Endovascular
Procedures
Less invasive percutaneous procedures to repair blood flow through the aorta to intestines, organs and extremities.
Mesenteric artery angioplasty
Renal artery angioplasty
Aorta angioplasty
Iliac artery angioplasty
Subclavian artery angioplasty
Hybrid
Procedures
Combined endovascular and opens surgical procedures to repair abdominal aorta aneurysms, thoracic aneurysm or to improve blood flow to the extremities.
Endovascular abdominal aorta aneurysm repair
Endovascular thoracic aorta aneurysm repair
If you have any problems with any of these conditions, please contact your General Practitioner, or your Vascular Surgeon. If you live in Pretoria and have not seen a Vascular Surgeon before, you are more than welcome to contact my rooms for a formal consultation.
Gregory Weir Vascular Surgery
The purpose of this web site is to offer Dr Weir’s patients and their families access to information regarding vascular disease in general as well as specific information on certain disease processes. The information on this site does not necessarily apply to all patients with the same diagnosis. If you are not a patient of Dr Weir, please do not regard the information on this website as a substitute for a thorough assessment by a qualified Vascular Surgeon. If in doubt, consult your doctor.
If you are experiencing a medical emergency, phone us. If you are not able to get through or if we are not available, please visit your nearest casualty department.
Consultation Rooms
Vascular & Hyperbaric Unit, Life Eugene Marais Hospital, Pretoria