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November 22, 2009
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Abdominal Aortic Aneurysm (cont.)

What are the complications with an abdominal aortic aneurysm?

Rupture is a feared problem. Rupture of an abdominal aneurysm is a catastrophe. It is highly lethal and is usually preceded by excruciating pain in the lower abdomen and back, with tenderness of the aneurysm. Rupture of an abdominal aneurysm causes profuse bleeding and leads to shock. Death may rapidly follow. Half of all persons with untreated abdominal aortic aneurysms die of rupture within five years. Abdominal aortic aneurysms are the 13th leading cause of death in the U.S.

Peripheral embolization of clot within the aneurysm can occur when a piece of clot comes loose and travels further out in the arterial system. This clot fragment can lodge in a smaller artery and block the flow of blood. Infection of aneurysms can occur from turbulent blood flow from the rough inner surface of the affected aorta.

How are abdominal aortic aneurysms repaired?

The goal of surgical treatment of abdominal aortic aneurysm is to prevent aneurysm rupture. Traditionally, repair of aortic aneurysms has been surgical. The operation consists of opening the abdomen, finding the aorta and removing (excising) the aneurysm. A synthetic Dacron tube that replaces the removed piece of aorta is sewn into place.

A less invasive procedure for aortic aneurysm is endovascular surgery. This minimally invasive procedure that allows the grafts (stent) to be guided within the blood vessel itself to the site of the aneurysm without the need to cut open the abdomen. Not all aneurysms can be fixed in this manner and there may not be a long-term benefit to this type of surgery. Though the post-operative course is shorter, there is a need for closer follow-up and testing.

Picture of grafted stent to repair an abdominal aortic aneurysm



Next: What is done if an abdominal aortic aneurysm threatens to rupture? »

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