Aortic Aneurysms – a ticking time bomb

An aortic aneurysm is an enlarged aorta, usually more than 4 cm in diameter. The risk of dying from having this disease is an average of 1.1% a year.

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Understand your problem  

The aorta is the main blood vessel carrying blood from the heart to the rest of the body. An aortic aneurysm happens when the wall of aorta becomes weakened and thinned out, causing it to balloon out. It may occur at any point along the aorta and the most common place is in the abdomen. Aortic aneurysms can lead life-threatening bleeding when they rupture.

 

Aortic aneurysms usually do not cause any symptoms and often discovered coincidentally when an individual undergoing imaging of the abdomen for another reason. If you experience symptoms such as severe back pain and abdominal pain, it may be a sign of impending rupture and requires urgent intervention.

 

Aortic aneurysms do not develop overnight but over several years. The risk factors include hypertension, high cholesterol, coronary artery disease, peripheral arterial disease, smoking, connective tissue disorders (such as Marfan’s syndrome) and trauma.

Seek for Treatment

Treatments for aortic aneurysms are based on the size and growth of the aneurysms.

The common reasons for intervention include:

 

  • Aortic size more than 5.5cm
  • Back or abdominal pain

 

A computerised tomography (CT) scan of the aorta is required when planning for an intervention. Our vascular surgeon Dr Lee Chee Wei  will discuss the treatments accordingly during the consultation in the clinics.

 

Small aortic aneurysms don’t need surgery and can be followed up with a duplex scan of the aorta 6 monthly basis for monitoring. This is a non-invasive scan and it can avoid radiation exposure.

 

If the aortic aneurysms are larger than 5.5cm, some form of intervention is advisable to reduce the risk of rupture and death.

Open repair of the aortic aneurysm
  • This requires a long abdominal incision to gain access to the aorta.
  • A prosthetic tube is then sutured in place of the thinned out aorta.
  • Associated with a mortality risk of around 3-5%.
  • The need to clamp the aorta during the surgery places the heart under strain and may lead to heart problems after the surgery.
EndoVascular Aortic Repair (EVAR)
  • This involves placing a stent-graft inside the aneurysmal aorta to prevent continued pressurization of the aortic sac.
  • The stent-graft is inserted from the femoral arteries via incisions at the groin.
  • This avoids a major abdominal incision and clamping of the aorta and is associated with lower risk of mortality.

 

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